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HIV-infected individuals are at elevated risk for progression from latent to active tuberculosis (TB). However, TB diagnosis in asymptomatic individuals is hampered by low sensitivity of the tuberculin skin test (TST), especially among those with advanced immune suppression, and cross-reactivity between the TST and the bacille Calmette-Guérin (BCG) vaccine. Might combined use of the TST and the T-SPOT.TB interferon-γ release assay lead to more-accurate diagnosis?
To find out, researchers in Taiwan — where TB prevalence is moderate and the BCG coverage rate is high — conducted a prospective study involving HIV-infected, BCG-vaccinated adults (N=909; median age, 35; 88% male; 50% men who have sex with men; 40% intravenous drug users) who had n…