Abstract
In Reply.— Drs Brown and Felton's response to our article raises several important points regarding future research in HIV infection and tuberculosis in the setting of drug treatment programs. Briefly reviewing current knowledge and recommendations may help clarify the issues. Clients of drug treatment programs are often at elevated risk for infection with both HIV and Mycobacterium tuberculosis . Isoniazid chemoprophylaxis is recommended for intravenous drug users with Mantoux tuberculin skin test induration of greater than 10 mm, if they are free of clinical tuberculosis and isoniazid therapy is not contraindicated. 1 However, if a patient is HIV seropositive, isoniazid chemoprophylaxis is recommended when induration is 5 mm or greater. The potential for recent M tuberculosis infection in HIV-infected persons to progress to clinical tuberculosis was certainly recognized in our article when we suggested the possibility of inmate-to-inmate transmission in at least one cluster of three cases. More recently, attention has
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