June
2007
TB: does a PPD+ test mean you have tuberculosis?
Tuberculosis (TB): what does PPD+ test mean?
TB (tuberculosis) is a very old bacterial disease that has killed millions and millions of people in the world throughout time. However in the US, TB cases dropped between 1953 to 1985 (from 84,304 to 22,201 per year). With HIV & AIDS, the cases has increased since 1985.
PPD is something everyone hears about but don’t quit understand. It is a skin test to see if a person has been infected with TB. TB usually doesn’t cause active disease (such as the classic pneumonia) right away. In HIV negative people maybe 2-5% will have active TB in the first 3 months (this is called Primary Infection). Some studies indicated primary TB infection might be more like 10% in HIV negative people. For others, TB lays dormant and harmless but there is a 10-20% lifetime risk of it becoming very active – usually when the immune system is down (this is called LTBI-latent tuberculosis infection
So the bottom line on PPD positive skin test: yes, the person has been infected with TB. But it doesn’t mean that person is contagious if the TB isn’t active. If it is dormant, it is a question of if it will become active to cause pneumonia, or even be active in other organs like the kidneys or nervous system.
Andrew Speaker, the personal-injury lawyer, is on the news June 2007 for traveling internationally with a MDR-TB (multi-drug resistant TB). MDR-TB means it is resistant to both antimicrobial drugs, isoniazid and rifampin – the hallmark drugs to cure TB. Often MDR-TB will be resistant to other antimicrobials as well, called XDR-TB: extensively drug-resistant TB. Because people often don’t take their TB medications as instructed (meaning missing doses or ending treatment early), TB strains are becoming resistant to the medicines.
Treatment of PPD+ skin test. Traditionally if someone was over the age of 35 and PPD+, no treatment was given (meaning isoniazid and/or rifampin) because the risk of liver failure on the isoniazid was greater than the risk of developing active TB. However, things have changed and if someone is PPD tested, they need to be prepared to take medicine for 9 months.
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drjohnhong 
infections, pulmonary 
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