Testing for human immunodeficiency virus infection in patients with tuberculosis

Area of Science:

• Infectious Diseases
• Public Health
• Epidemiology

Background:

• Tuberculosis (TB) and Human Immunodeficiency Virus (HIV) are significant global health concerns.
• Co-infection with TB and HIV presents unique diagnostic and treatment challenges.
• Understanding the prevalence of HIV among TB patients is vital for effective public health strategies.

Purpose of the Study:

• To evaluate the effectiveness of universal HIV testing in tuberculosis patients in Los Angeles.
• To determine the prevalence of HIV infection among hospitalized TB patients without a prior HIV diagnosis.
• To assess the utility of identifying HIV risk factors through interviews and medical record reviews.

Main Methods:

• Prospective evaluation of 183 hospitalized patients with smear-positive tuberculosis.
• HIV serologic testing was conducted for all participants.
• Assessment of HIV risk factors via patient interviews and medical record review.

Main Results:

• 18% (33 of 183) of tuberculosis patients were found to be HIV-infected.
• 68% (124 of 183) of patients reported at least one HIV risk factor, primarily related to heterosexual transmission.
• Risk factors were often undocumented in medical records, and systematic interviews identified risk factors in most, but not all, HIV-infected patients.

Conclusions:

• A significant proportion of tuberculosis patients in Los Angeles are co-infected with HIV.
• Relying solely on documented risk factors or patient interviews is insufficient for identifying all HIV-infected TB patients.
• Universal HIV screening for all tuberculosis patients is supported by these findings and aligns with current public health recommendations.