title: HIV and tuberculosis co-infection in an inner London hospital--a prospective anonymized seroprevalence study.
abstract: OBJECTIVE
  Since 1987 there has been an increase in tuberculosis notifications in the U.K., with this increase disproportionately affecting London. A recent national survey suggests that co-infection with HIV occurs in less than 5% of tuberculosis patients. This study asked if local co-infection rates in Inner London differed from the national results.
  
  
  METHODS
  157 consecutive patients starting antituberculous chemotherapy were venesected 2 weeks into treatment. Anonymized blood samples were screened for antibodies for HIV-1 and HIV-2 by enzyme-linked immunosorbent assay (ELISA). Epidemiological data were collected on each patient which was also coded before HIV test results were known.
  
  
  RESULTS
  Of 157 patients commencing antituberculous therapy, 39 patients (24.8%) were found to be co-infected with HIV-1. HIV-negative and positive patients were similar in terms of age and sex. When 98 patients giving their country of origin as other than Europe were considered there were 22 co-infected with HIV (22.4%). Of the 39 HIV-positive identified in this study, 37 were also identified by our voluntary HIV testing programme.
  
  
  CONCLUSIONS
  This study has shown that there may be very different rates of co-infection at a local level in the U.K. The local variation may be missed by national surveys and diverse local testing procedures. Anonymous testing identified only two patients with tuberculosis and HIV infection who were not identified by our voluntary HIV testing programme and this suggests that offering HIV tests to patients with tuberculosis is largely taken up by those at risk of HIV infection. Surveillance studies of this type are important in identifying marked local variation from the national pattern of HIV and Mycobacterium tuberculosis infection.
authors.affiliation: Department of Respiratory Medicine, St. Mary's NHS Trust, London, UK.
authors.forename: B G
authors.initials: BG
authors.lastname: Marshall
authors.forename: D M
authors.initials: DM
authors.lastname: Mitchell
authors.forename: R J
authors.initials: RJ
authors.lastname: Shaw
authors.forename: F
authors.initials: F
authors.lastname: Marais
authors.forename: R M
authors.initials: RM
authors.lastname: Watkins
authors.forename: R J
authors.initials: RJ
authors.lastname: Coker
mesh_terms: D017088:AIDS-Related Opportunistic Infections / Q000188:drug therapy / Q000453:epidemiology*; D000293:Adolescent; D000328:Adult; D000914:Antibodies, Viral / Q000097:blood; D000995:Antitubercular Agents / Q000627:therapeutic use; D002648:Child; D015897:Comorbidity; D005260:Female; D015658:HIV Infections / Q000453:epidemiology* / Q000821:virology; D015528:HIV Seroprevalence; D015497:HIV-1 / Q000302:isolation & purification*; D015498:HIV-2 / Q000302:isolation & purification*; D006760:Hospitalization; D006801:Humans; D015994:Incidence; D008131:London / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D014376:Tuberculosis / Q000188:drug therapy / Q000453:epidemiology*; D014505:Urban Population
chemical_list: D000914:Antibodies, Viral; D000995:Antitubercular Agents