Mycobacterium tuberculosis infection among persons who inject drugs in San Diego, California

• Published in: The international journal of tuberculosis and lung disease Vol. 21; no. 4; pp. 425 - 431
• Main Authors: Armenta, R. F., Collins, K. M., Strathdee, S. A., Bulterys, M. A., Munoz, F., Cuevas-Mota, J., Chiles, P., Garfein, R. S.
• Format: Journal Article
• Language: English
• Published: France International Union Against Tuberculosis and Lung Disease 01.04.2017
• Subjects: Adolescent; Adult; Aged; Aged, 80 and over; California - epidemiology; Coinfection; Cross-Sectional Studies; Female; Hepatitis C - epidemiology; Hepatitis C virus; HIV; HIV Infections - epidemiology; Human immunodeficiency virus; Humans; Injection Drug Use; Interferon-gamma Release Tests; Latent Tuberculosis - diagnosis; Latent Tuberculosis - epidemiology; Latent Tuberculous Infection; Lentivirus; Male; Middle Aged; Mycobacterium tuberculosis; Point-of-Care Systems; Prevalence; Pwid; Quantiferon®-Tb Gold In-Tube Assay; Retroviridae; Risk Factors; Substance Abuse, Intravenous - complications; Substance Abuse, Intravenous - epidemiology; Travel; Tuberculosis - diagnosis; Tuberculosis - epidemiology; Young Adult
• ISSN: 1027-3719; 1815-7920
• DOI: 10.5588/ijtld.16.0434

BACKGROUND: Persons who inject drugs (PWID) might be at increased risk for Mycobacterium tuberculosis infection and reactivation of latent tuberculous infection (LTBI) due to their injection drug use.OBJECTIVES: To determine prevalence and correlates of M. tuberculosis infection among PWID in San Diego, California, USA.METHODS: PWID aged 18 years underwent standardized interviews and serologic testing using an interferon-gamma release assay (IGRA) for LTBI and rapid point-of-care assays for human immunodeficiency virus (HIV) and hepatitis C virus (HCV) infections. Independent correlates of M. tuberculosis infection were identified using multivariable log-binomial regression.RESULTS: A total of 500 participants met the eligibility criteria. The mean age was 43.2 years (standard deviation 11.6); most subjects were White (52%) or Hispanic (30.8%), and male (75%). Overall, 86.7% reported having ever traveled to Mexico. Prevalence of M. tuberculosis infection was 23.6%; 0.8% were co-infected with HIV and 81.7% were co-infected with HCV. Almost all participants (95%) had been previously tested for M. tuberculosis; 7.6% had been previously told they were infected. M. tuberculosis infection was independently associated with being Hispanic, having longer injection histories, testing HCV-positive, and correctly reporting that people with 'sleeping' TB cannot infect others.CONCLUSIONS: Strategies are needed to increase awareness about and treatment for M. tuberculosis infection among PWID in the US/Mexico border region.