title: [Tuberculosis in HIV-positive and HIV-negative drug users in Amsterdam].
abstract: OBJECTIVE
  To determine and to compare the incidences of active tuberculosis in HIV positive and HIV negative drug users and to describe the main characteristics of the tuberculosis cases.
  
  
  METHODS
  Prospective.
  
  
  METHODS
  Municipal Health Service, Amsterdam, the Netherlands.
  
  
  METHODS
  Data of the ongoing cohort study of HIV infection in Amsterdam drug users, including HIV serostatus and CD4 cell counts, from 1986 until 1996 were completed with data from the tuberculosis registration of the tuberculosis department of the Amsterdam Municipal Health Service and analysed statistically.
  
  
  RESULTS
  Of 872 participants 24 persons developed culture confirmed tuberculosis during a total follow-up period of 4000 person years (py) (0.6 per 100 py). Nineteen persons were HIV positive (1.54 per 100 py) and 5 HIV negative (0.18 per 100 py). Multivariately, HIV infection and higher age increased the risk of tuberculosis substantially (relative risks 12.9; 95% confidence interval (CI): 3.4-48.8 and 6.8: 95% CI: 1.3-35.0 respectively). Thirteen of 22 pulmonary tuberculosis cases (59%) were detected by half-yearly X-ray screening of the chest. Tuberculosis occurred relatively early in the course of HIV infection at a mean CD4 cell number of 390/microliter. All but one patient completed the tuberculosis treatment.
  
  
  CONCLUSIONS
  HIV infection increases the risk of active tuberculosis in Amsterdam drug users 13-fold. The incidence of tuberculosis in HIV negative drug users in 6 times higher than that in the overall Amsterdam population. Periodic chest X-ray screening contributes substantially to case-finding of active tuberculosis in Amsterdam drug users.
authors.affiliation: GG&GD, divisie Volksgezondheid en Milieu, afd. Tuberculosebestrijding en Aidsonderzoek, Amsterdam.
authors.forename: S T
authors.initials: ST
authors.lastname: Keizer
authors.forename: M W
authors.initials: MW
authors.lastname: Langendam
authors.forename: H
authors.initials: H
authors.lastname: van Deutekom
authors.forename: R A
authors.initials: RA
authors.lastname: Coutinho
authors.forename: F J
authors.initials: FJ
authors.lastname: van Ameijden
mesh_terms: D017088:AIDS-Related Opportunistic Infections; D000328:Adult; D018791:CD4 Lymphocyte Count; D015331:Cohort Studies; D005260:Female; D018023:HIV Seronegativity; D006679:HIV Seropositivity / Q000150:complications*; D006801:Humans; D015994:Incidence; D008297:Male; D009426:Netherlands / Q000453:epidemiology; D015995:Prevalence; D011446:Prospective Studies; D012307:Risk Factors; D015819:Substance Abuse, Intravenous / Q000150:complications; D019966:Substance-Related Disorders / Q000150:complications; D014397:Tuberculosis, Pulmonary / Q000175:diagnosis / Q000453:epidemiology*