Epidemiology of extrapulmonary tuberculosis among persons with AIDS in the United States

AIDS surveillance data reported to the Centers for Disease Control from January 1981 through December 1991 were analyzed in a study characterizing persons with human immunodeficiency virus (HIV) infection and extrapulmonary tuberculosis (EPTB) in the United States. Among 206,392 persons reported to have AIDS, 4,751 (2.3%) were also reported to have EPTB; of these cases, 4,257 (90%) were reported after September 1987, when the case definition for AIDS was revised to include EPTB. Seventy-six percent of persons in whom AIDS and EPTB were reported after this revision were born in the United States; among these persons, the annual percentage with EPTB in 1988-1991 ranged from 2.3% to 2.5%. The South and the Northeast accounted for 73% of EPTB cases in U.S.-born persons. U.S.-born non-Hispanic blacks (odds ratio [OR], 3.3) and U.S.-born Hispanics (OR, 2.1) were more likely than U.S.-born non-Hispanic whites to be reported as having EPTB. Intravenous drug users were at higher risk (OR, 2.9) than men who reported having had sex with other men. With the resurgence of tuberculosis and the continued expansion of the HIV epidemic, these data provide a useful basis for the targeting of efforts to control tuberculosis and to prevent HIV infection.