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Human immunodeficiency virus infection in tuberculosis patients
C P Theuer1, P C Hopewell, D Elias
1Medical Service, San Francisco General Hospital, California.
The Journal of Infectious Diseases
|July 1, 1990
Summary
Human immunodeficiency virus (HIV) screening is recommended for tuberculosis patients, especially in endemic areas. HIV-positive individuals with tuberculosis showed lower CD4+ cell counts and ratios, regardless of risk behavior disclosure.
Area of Science:
- Infectious Diseases
- Immunology
- Public Health
Background:
- Tuberculosis (TB) is a significant global health concern.
- Co-infection with Human Immunodeficiency Virus (HIV) complicates TB management and outcomes.
- Understanding the prevalence and characteristics of HIV in TB patients is crucial for effective public health strategies.
Purpose of the Study:
- To determine the prevalence of HIV seropositivity in non-Asian-born patients diagnosed with tuberculosis.
- To compare demographic and clinical features between HIV-seropositive and HIV-seronegative TB patients.
- To assess the association between HIV infection and clinical presentation, immune status, and treatment outcomes in TB patients.
Main Methods:
- HIV serology testing was conducted on eligible non-Asian-born TB patients aged 18-65.
- Demographic data (race/ethnicity, reported risk behaviors) and clinical information (disease site, tuberculin reactivity, treatment response) were collected.
- Statistical analysis was used to compare HIV-seropositive and HIV-seronegative groups, including CD4+ cell counts and CD4+:CD8+ ratios.
Main Results:
- Of 128 eligible patients, 60 participated, with 17 (28%) found to be HIV-seropositive.
- HIV risk was associated with homosexual contact or intravenous drug use, but 24% of seropositives denied risk behaviors.
- Black patients had a significantly higher HIV seroprevalence (48%) compared to white (10%) or Latino (20%) patients (P < .01).
- HIV-seropositive patients exhibited significantly lower median CD4+ cell counts and CD4+:CD8+ ratios compared to seronegative patients (P < .0001 for both).
- No significant differences were observed in disease site, tuberculin reactivity, treatment response, drug toxicity, or relapse rates between the groups.
Conclusions:
- HIV infection is common among tuberculosis patients in this setting, even in those denying risk behaviors.
- Race/ethnicity is a significant factor in HIV prevalence among TB patients.
- HIV-positive TB patients present with impaired immune function, indicated by lower CD4+ counts and ratios.
- Routine HIV screening for tuberculosis patients is recommended, particularly in areas where HIV is endemic, to facilitate timely diagnosis and management.