The Latent Tuberculosis Infection Prevalence and Characteristics in the HIV Disease Population in Two Major Medical Centers in Tegucigalpa, Honduras

Author(s): Mirams T Castro-Lainez, Cecilia Varela-Martinez, Rebeca Rivera, Jose A Diaz-Romero, Leticia N Solorzano-Flores, Alan Howell, Fernando Baires, Miguel Sierra-Hoffman, Mark L Stevens, Elsa Palou-Garcia, Rafael J Deliz

Background: In Honduras, thirteen percent of patients with tuberculosis are coinfected with HIV, but the prevalence of latent tuberculosis infection among people with HIV infection is unknown. The goal of this study is to determine the prevalence and characteristics of latent tuberculosis infection among HIV diagnosed patients.

Methods: A cross-sectional study was conducted from June 2015 to December 2015 in two major clinical centers in Tegucigalpa, Honduras. This study used an adapted questionnaire-based clinical algorithm from the World Health Organization, procedures described by the Pan American Health Organization, and the Honduran National Norms for Tuberculosis Control included in the supplement material. There were two hundred ten individuals interviewed. Laboratory testing included tuberculin skin testing with absolute CD4 counts.

Results: There was a statistically significant higher risk of latent tuberculosis infection with HIV disease in the subgroups with a lower level of education (p = 0.002) and prior history of tuberculosis (p < 0.001).

Conclusion: The prevalence of latent tuberculosis infection is lower than in high-prevalence regions in different countries. The tuberculin skin test continues to identify patients with latent tuberculosis with HIV disease and intervene with concurrent antiretroviral therapy and tuberculosis chemoprophylaxis. A low education level is probably related to low socioeconomic status and access to healthcare. The findings of this study represent an opportunity to reach underserved areas, test the HIV population with the tuberculin skin test, and administer chemoprophylaxis.