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  • Title: Presumptive TB prophylaxis rejected.
    Author: Torres G.
    Journal: GMHC Treat Issues; 1997 Oct; 11(10):5-6. PubMed ID: 11364822.
    Abstract:
    HIV-infected people have low sensitivity to standard tuberculosis or purified protein derivative (PPD) testing, prompting the Center for Disease Control and Prevention (CDC) to recommend the use of isoniazid for high-risk HIV-positive individuals. The National Institute of Allergy and Infectious Diseases (NIAID) tested isoniazid's effectiveness compared to PPD and two anergy skin tests and determined that isoniazid prophylaxis was not useful in preventing tuberculosis in this high-risk group. It was also determined that the use of preventive therapy among HIV-infected persons with anergy was not warranted, except for those who have been in close contact with someone known to have active tuberculosis. The Public Health Service/Infectious Disease Society of America recommends discontinuing isoniazid prophylaxis in cases of anergic individuals. They continue to recommend PPD skin testing annually in HIV-positive persons irrespective of their CD4 counts.
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