Cumulative AIDS incidence and altered mortality from mycobacterial disease: New Jersey

Changes in mycobacterial disease mortality between 1980 and 1986 were examined among New Jersey residents aged 25 to 44 using single cause of death data. The demographic group with the highest cumulative incidence of acquired immune deficiency syndrome (AIDS) (non-white residents of the four urban counties adjacent to New York City) sustained an increase of 10.1 deaths/100,000 men/yr and 3.1 deaths/100,000 women/yr. Groups with lower cumulative incidence of AIDS sustained smaller increases in mycobacterial disease mortality. The group with the lowest cumulative incidence of AIDS (white residents outside the four urban counties adjacent to New York City) sustained the smallest increase in tuberculosis (TB) mortality. Using single cause of death data, it was not possible to identify a relationship between increased extrapulmonary TB deaths and AIDS cumulative incidence, but such a relationship was identifiable from multiple cause of death data. Of 30 mycobacterial disease deaths of all ages with cellular immune deficiency as a contributory diagnosis on the death certificate, 21 (70%) were known to the state's AIDS registry as AIDS cases and four more (13%) were known to the registry as having human immunodeficiency virus (HIV) disease not meeting the full clinical criteria for AIDS. Young populations with a high cumulative incidence of AIDS have experienced substantially increased mortality from mycobacterial diseases. The association of mycobacterial disease mortality with HIV disease may be underestimated from AIDS registry data and from searches of single cause of death data for mycobacterial disease deaths.