Injection drug users (IDUs) were heavily affected by the tuberculosis (TB) resurgence in New York City in the 1990s. We assessed the effectiveness of screening for latent TB infection in methadone users and of selective treatment with isoniazid. Risk for future TB was classified as low or high on the basis of tuberculin, anergy, and HIV test results. The cohort of 2212 IDUs was followed up for a median of 4.2 years; 25 IDUs, of whom 20 (80%) were infected with human immunodeficiency virus (HIV), developed TB. In an adjusted Cox proportional hazards model of high-risk IDUs, the risk of TB was associated with HIV infection (HR 10.3; 95% CI, 3.4-31.3); receipt of <6 months of isoniazid therapy (HR 7.6; 95% CI, 1.02-57.1); a CD4+ T lymphocyte count of <200 cells/mm3 (HR 6.6; 95% CI, 1.7-25.9); and tuberculin positivity (HR 4.0; 95% CI, 1.6-10.2). Treatment with isoniazid was beneficial in HIV-infected, tuberculin-positive IDUs.

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During a period of high tuberculosis incidence in NYC, 3% of HIV-infected children in our cohort had tuberculosis, higher than the rate in uninfected children born to HIV-positive mothers in the same cohort. Because of this association, HIV-infected children with pulmonary illness should be tested for tuberculosis; and all children with tuberculosis should be tested for HIV.

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Quantitative EPR technique was applied to examine Cu(lI) complexes and free radicals in soil and municipal solid waste composts. Production and stabilization of free radicals in humic and humic-like substances depend on transition metal containing red-ox systems in soil. Termination of the reaction pathways yields relatively stable semiquinone free radicals in the polyphenol and melanoidin matrices. EPR investigations of municipal solid waste composts in different stages of their maturity show distinct correlation between free radical concentration and microbiological activity. Copper(II) sorption by living microorganisms and formation of the copper(II) complexes by humic substances in soils (Cambisols and Luvisols) result in decrease of the concentration of the semiquinone radicals. The Cu(II) complexes formed by various natural humic and humic-like substances produced in the composts were characterized on the basis of EPR measurements. The process of solubilization of inorganic copper compounds in soil and composts, and free radical activity in soil and composts can be characterized using EPR technique as the monitoring method.