Testing for HIV among patients with tuberculosis in Montreal

To determine the rate of HIV testing among patients with tuberculosis (TB) in Montreal, and to identify patient characteristics associated with physician screening patterns. Knowledge of local patterns of HIV testing among patients with TB could be used to facilitate the development of strategies to improve compliance with recommendations that all patients with TB be screened for HIV.

Retrospective chart review.

All patients with TB reported to the Montreal Public Health Unit from 1992 to 1994 (ages 19 to 50) and from 1992 to 1995 (ages 18 and under) and for whom a chart could be reviewed.

Patients with TB screened versus not screened for HIV infection, analyzed to determine which variables independently predict the likelihood of screening for HIV infection.

Of the 376 patients with TB for whom data were available, 192 (51%) were screened for HIV. Of those, 33 (17%) had been tested before having received the diagnosis of TB. Multivariate analysis revealed that patients with TB who were male, aged 30 to 39, had a positive sputum smear, displayed at least 1 clinical symptom, received the TB diagnosis from a microbiologist or infectious disease specialist, or reported 1 or more HIV risk factors were more likely to be screened for HIV.

HIV screening of patients with TB is selective, depending on both patient and physician characteristics. Physicians' awareness of recommendations needs to be increased to improve the diagnosis and treatment of TB/HIV co-infection.