Outbreaks of tuberculin skin test conversions among U.S. Army personnel are likely to be false positives, and the personnel have a low risk of tuberculosis infection due to limited exposure to locals, researchers report in the June 1 issue of the American Journal of Respiratory and Critical Care Medicine.

James D. Mancuso, M.D., from the Uniformed Services University of the Health Sciences in Bethesda, Md., and colleagues investigated eight pseudoepidemics of tuberculin skin test conversions in U.S. Army populations. Five of these were associated with overseas deployments.

The researchers found that although the risk of conversion had initially been reported as 1.3 to 15 percent, 30 to 100 percent of personnel with positive tests were negative on retesting. False positive results were attributed to factors such as variability in reading and administration, product variability and cross-reactivity to unrelated mycobacteria.

"Pseudoepidemics of tuberculin skin test conversions are a common occurrence after U.S. Army deployments and in U.S. Army populations," Mancuso and colleagues conclude. "U.S. Army forces generally have a low risk of tuberculosis infection resulting from deployments due to limited exposure to local nationals with active tuberculosis, and universal testing in this population has a low positive-predictive value."

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