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May 13, 1992

TB or not TB, That Is the Question-Reply

Author Affiliations

The Johns Hopkins University Baltimore, Md

JAMA. 1992;267(18):2472. doi:10.1001/jama.1992.03480180057024

In Reply.  —Drs Jolson and Behrman raise the question whether differential enrollment of HIV-seropositive and HIV-seronegative patients could explain the differences in tuberculin positivity we observed in our study.1 In particular, they wondered if more rigorous screening or higher previous TB rates in the HIV-seropositive patients might explain the difference.To determine if this occurred, we reanalyzed data from those patients who were not tested (n=52). We observed no relationship between HIV serostatus and not being tested (P=.53). Thirty-seven of these patients were not tested because they had previous positive tuberculin tests (HIV seronegative, 19 patients; HIV seropositive, 15 patients) or a history of TB (HIV seronegative, one patient; HIV seropositive, two patients). Clearly these cases are equally distributed between groups and could not have influenced our results.Jolson and Behrman also suggest combining past history and current test results. This approach does give additional information about prior