Two-step tuberculin skin testing in drug users

Shobha Swaminathan, Ellie E. Schoenbaum, Robert S. Klein, Andrea A. Howard, Yungtai Lo, Marc N. Gourevitch

Research output: Contribution to journalArticlepeer-review


To assess the utility of booster testing and to identify factors associated with a positive booster test, two-step tuberculin testing was performed in drug users recruited from methadone treatment. Participants also received a standardized interview on demographics and testing for HIV and CD4+ lymphocyte count. Of 619 enrollees completing the protocol, 174 (28%) had a positive PPD and 24 of the remaining 445 (5%) had a positive booster test. On multivariate analysis, boosting was associated with older age (adjusted odds ratio [ORadj] 2.38/decade, 95% confidence interval [CI] 1.34-4.22), history of using crack cocaine (ORadj 2.61, 95% CI 1.10-6.18) and a history of working as a home health aide (ORadj 4.23, 95% CI 1.39-12.86). Two-step tuberculin skin testing increased the proportion of participants with latent tuberculosis infection from 22% to 25%. Given the effectiveness of chemoprophylaxis, booster testing should be considered when drug users are screened for tuberculosis infection.

Original languageEnglish (US)
Pages (from-to)71-79
Number of pages9
JournalJournal of Addictive Diseases
Issue number2
StatePublished - May 24 2007


  • Drug users
  • Skin testing
  • Tuberculosis

ASJC Scopus subject areas

  • Medicine (miscellaneous)
  • Clinical Psychology
  • Psychiatry and Mental health


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