A cross-sectional study of HIV and tuberculosis coinfection cases in mainland China

The prevalence of HIV/AIDS and tuberculosis (TB) within mainland China is unprecedented and the convergence of these two infectious diseases is increasingly and significantly endangering human health for socioeconomic development. To date, the clinical manifestations, laboratory presentation, and epidemiologic features of HIV/TB coinfection cases in mainland China have not been described in detail. To assess the incidence, clinical characteristics and outcome of coinfection with HIV and TB, we conducted a cross-sectional study of coinfected cases reported from nine domestic hospitals throughout mainland China.

During the 3-year survey period from January 2003 to December 2005, all patients were followed regularly. Medical records were reviewed, a standardized questionnaire was administered, and clinical databases were analyzed.

A total of 241 cases (183 male, 58 female) with pulmonary TB, extrapulmonary TB, or both, accounted for 9.5%, 21.6%, and 18.7% of cases, respectively. Among the 241 reported cases of HIV/TB coinfection, 76.8% had CD4 cell counts 200/mm3 and 58.5% were 100/mm3. Treatments for TB and HIV were provided to patients and mortality attributable to coinfection was reported for 15.8% of the cases.

The clinical characteristics of HIV/TB coinfection varied among the 241 cases studied with pulmonary TB predominating. Immune function among most patients was suppressed based on reduced CD4+ T cell counts. HIV/TB coinfection was related to high mortality even when HAART and/or drug therapy for TB was provided. Additional sensitive techniques are needed to improve the diagnosis of HIV/TB coinfection.