title: A retrospective cohort study of the risk of tuberculosis among women of childbearing age with HIV infection in Zaire.
abstract: To determine the risk of active tuberculosis associated with HIV infection, we retrospectively studied a cohort of HIV-seropositive and HIV-seronegative women participating in an HIV perinatal transmission study in Kinshasa, Zaire. After a median follow-up of 32 months, new cases of proven pulmonary or clinically diagnosed tuberculosis occurred in 19 of the 249 HIV-seropositive women (7.6%, 3.1 cases per 100 person-years) compared with 1 of the 310 HIV-seronegative women (0.3%, 0.12 cases per 100 person-years), for a relative risk of 26 (95% confidence interval, 5 to 125). Proven pulmonary tuberculosis was diagnosed in 7 HIV-seropositive women (2.8%, 1.2 cases per 100 person-years) and 1 HIV-seronegative woman (0.3%, 0.12 cases per 100 person-years), for a relative risk of 10 (95% confidence interval, 1.5 to 47). We estimated that 66 cases of proven pulmonary tuberculosis in 100,000 person-years of follow-up in women of childbearing age could be attributed to HIV; this is 35% of their estimated total incidence of proven pulmonary tuberculosis. Among those followed for 2 yr, 27 (11%) of 243 HIV-seropositive women died during 2 yr of follow-up compared with none of 296 HIV-seronegative women (p less than 0.001). In HIV-seropositive women with proven or clinically diagnosed tuberculosis mortality was even higher: 5 (26%) of the 19 HIV-seropositive women with proven pulmonary or clinically diagnosed tuberculosis died during follow-up compared with 22 (10%) of the 224 HIV-seropositive women not diagnosed as having tuberculosis (relative risk 2.7; 95% confidence interval, 1.1 to 6.3).(ABSTRACT TRUNCATED AT 250 WORDS)
authors.affiliation: Division of HIV/AIDS, Centers for Disease Control, Atlanta, Georgia.
authors.forename: M M
authors.initials: MM
authors.lastname: Braun
authors.forename: N
authors.initials: N
authors.lastname: Badi
authors.forename: R W
authors.initials: RW
authors.lastname: Ryder
authors.forename: E
authors.initials: E
authors.lastname: Baende
authors.forename: Y
authors.initials: Y
authors.lastname: Mukadi
authors.forename: M
authors.initials: M
authors.lastname: Nsuami
authors.forename: B
authors.initials: B
authors.lastname: Matela
authors.forename: J C
authors.initials: JC
authors.lastname: Willame
authors.forename: M
authors.initials: M
authors.lastname: Kaboto
authors.forename: W
authors.initials: W
authors.lastname: Heyward
mesh_terms: D000293:Adolescent; D000328:Adult; D015331:Cohort Studies; D015023:Democratic Republic of the Congo / Q000453:epidemiology; D005260:Female; D015658:HIV Infections / Q000150:complications*; D006679:HIV Seropositivity / Q000150:complications; D006801:Humans; D012189:Retrospective Studies; D012307:Risk Factors; D014376:Tuberculosis / Q000150:complications* / Q000453:epidemiology; D014388:Tuberculosis, Lymph Node / Q000150:complications; D014396:Tuberculosis, Pleural / Q000150:complications; D014397:Tuberculosis, Pulmonary / Q000150:complications