Risk factors for tuberculin skin test conversion among HIV-infected patients in New York City

Background: We assessed the incidence of and risk factors for tuberculin skin test (TST) conversion among HIV-infected adults at a New York City clinic. Methods: All adult HIV-infected patients were eligible for inclusion if they had a negative baseline TST result and at least one subsequent documented TST test result. Results: A total of 414 HIV-infected patients had a negative baseline TST result; 288 (69.6%) were male. Among 348 patients who had a place of birth documented, 50% were born outside of mainland USA. Twenty-two (5.3%) of 414 patients had documented TST conversions, giving a crude incidence rate of 1.77 per 100 person-years. Being a foreign-born Asian individual (p = 0.02), having lived in a shelter (p = 0.004), and having an increase in CD4 cell count (p = 0.02) while under care were independent risk factors for TST conversion. Conclusions: We found a high TST conversion rate among HIV-infected patients attending an urban clinic. Annual TST testing is particularly important for patients who are foreign-born from high-endemic countries, those with a history of homelessness, and those with an increase in CD4 cell count since the baseline negative TST test. (C) 2012 International Society for Infectious Diseases. Published by Elsevier Ltd. All rights reserved.