Tuberculin Skin Test Response in Patients Newly Diagnosed with HIV in Cotonou, Benin: A Cross-Sectional Study - Abstract
Objective: To determine the prevalence of positive tuberculin skin test among patients newly diagnosed with HIV and to evaluate how it varies across CD4+ T cell ranges. Methods: A cross sectional study was conducted in 2012-2013 on persons who tested positive for HIV after voluntary counselling and testing in four HIV clinics in Cotonou. Data on Tuberculin skin test (TST) in duration, CD4+T cell count, sex, age and presence of Bacille Calmette Guerin (BCG) post-vaccination scar were collected. Results: A total of 644 persons living with HIV (PLWH) were included out of which 301 persons (46.7%) had CD4+ T cell below 200 cells/?l. Overall, participants were more often female (69.7%) and had a mean (SD) age of 35.9 (9.8) years. The TST-positivity rate was 34.0 % (30.5- 37.8) when a 5mm TST cut-off was used. In any range of CD4T+ cell count, the odds (unadjusted and adjusted) of having a positive TST were relatively similar across TST cut-offs. Consistently, the odds of having a positive TST decreased with lower levels of CD4+ T cell count. Conclusion: Only 1 in 3 patients newly diagnosed with HIV in Benin had a positive tuberculin skin test at the time of diagnosis. This needs to be taken into account for the implementation of Isoniazid Preventive Therapy among PLWH in Benin.