Tuberculosis in those with HIV infection

Area of Science:

• Infectious Diseases
• Public Health
• Epidemiology

Background:

• Co-infection with tuberculosis and human immunodeficiency virus (HIV) presents significant global health challenges.
• Understanding the specific epidemiology of tuberculosis and HIV in diverse populations is crucial for targeted interventions.

Purpose of the Study:

• To investigate the incidence, demographics, clinical characteristics, treatments, and outcomes of patients with co-occurring tuberculosis and HIV infection in Auckland, New Zealand.
• To identify trends and risk factors associated with this co-infection within the Auckland region.

Main Methods:

• A retrospective review of patient records was conducted for individuals with HIV infection and tuberculosis treated by the Infectious Disease Unit at Auckland Hospital.
• Data were collected from 1984 to December 31, 1995, encompassing the early years of the HIV epidemic in New Zealand.

Main Results:

• Eleven cases of tuberculosis and HIV co-infection were identified, representing 2.4% of HIV-infected patients. The majority were male and homosexual, with a median age of 30.
• Incidence varied significantly by ethnicity: 1.2% in Pakeha, 20% in Maori, and 27% in Africans. A rising incidence was observed after 1990.
• Most Mycobacterium tuberculosis strains were drug-sensitive; multidrug resistance was rare. Outcomes included death from HIV (seven patients), ongoing treatment (three), and relapse (one).

Conclusions:

• Tuberculosis is an uncommon but increasingly recognized complication of HIV infection in Auckland.
• Maori and African populations exhibit a disproportionately high risk for tuberculosis in the context of HIV infection.
• Healthcare providers must maintain vigilance for tuberculosis in HIV-infected patients and for HIV infection in tuberculosis patients.