TY - JOUR T1 - Should Tuberculin Skin Test Be Positive to Give Latent Tuberculosis Treatment Before Tumor Necrosis Factor-α Inhibitors in Selected Patients in Developing Countries? JF - The Journal of Rheumatology JO - J Rheumatol SP - 672 LP - 673 DO - 10.3899/jrheum.090672 VL - 37 IS - 3 AU - CARLOS ABUD-MENDOZA AU - MARCO ULISES MARTÍNEZ-MARTÍNEZ AU - JOSÉ DE JESÚS MACÍAS-MENDOZA AU - MARTÍN MAGAÑA-AQUINO Y1 - 2010/03/01 UR - http://www.jrheum.org/content/37/3/672.abstract N2 - To the Editor:We read with interest the report by Malaviya, et al about tuberculosis (TB) and inflammatory rheumatic disease (IRD) patients receiving tumor necrosis factor-α (TNF-α) inhibitor agents1. Mexico also has a “high TB burden,” with estimated prevalence of at least 23 per 100,0002. The tuberculin skin test (TST) has low sensitivity, including in high-risk population groups such as men and patients older than 50 years, in addition to those who have disseminated TB3,4. In immunosuppressed patients (such as those with human immunodeficiency virus), tuberculin anergy is reported to be > 40%, particularly in those with poor body mass index and/or severe lymphopenia5. This could also be true about other immunodeficient persons, including patients with rheumatic disease who are taking disease-modifying antirheumatic drugs (DMARD) and corticosteroids6,7.One … Address correspondence to Dr. Abud-Mendoza; E-mail: c_abud{at}hotmail.com ER -