Risk of development of tuberculosis in HIV-infected patients.
OBJECTIVE
To estimate the rate of development of active tuberculosis (TB) in a cohort of human immunodeficiency virus (HIV) positive patients, and to identify the characteristics of these patients.


METHODS
A total of 175 HIV-positive individuals were recruited from clinics for sexually transmitted diseases and followed up for 31 +/- 6.8 months. Clinical examination, chest X-ray, sputum smear for acid-fast bacilli and culture for mycobacteria and HIV serology were performed at the time of registration and repeated periodically.


RESULTS
Seventeen patients had TB at intake and another 24 developed TB during follow-up, giving a breakdown rate of 6.9/100 person-years (p-y) (95% confidence interval [CI] 4.1-9.6). The attack rates were similar in tuberculin positive (7.1/100 p-y, 95%CI 3.4-10.8) and negative (6.7/100 p-y, 95%CI 2.6-10.8) patients. There was a trend towards higher mortality in patients who developed TB (10.5/100 p-y, 95%CI 4.8-15.2) compared to those who did not (6.1/100 p-y, 95%CI 3.2-8.8).


CONCLUSIONS
The results of this study provide information regarding the high risk of development of active tuberculosis and its associated mortality in HIV-infected persons. The risk of developing TB appears to be equally high in tuberculin positive and negative individuals, suggesting that new infections could play a major role in this susceptible population.
Swaminathan
S
S
Tuberculosis Research Centre, Indian Council of Medical Research, Chetput, Chennai.
Ramachandran
R
R
Baskaran
G
G
Paramasivan
C N
CN
Ramanathan
U
U
Venkatesan
P
P
Prabhakar
R
R
Datta
M
M
D017088:AIDS-Related Opportunistic Infections / Q000175:diagnosis / Q000209:etiology* / Q000382:microbiology / Q000401:mortality*; D000328:Adult; D017677:Age Distribution; D005260:Female; D006801:Humans; D015994:Incidence; D007194:India / Q000453:epidemiology; D008297:Male; D011159:Population Surveillance; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012307:Risk Factors; D017678:Sex Distribution; D013183:Sputum / Q000382:microbiology; D016019:Survival Analysis; D014374:Tuberculin Test; D014376:Tuberculosis / Q000175:diagnosis / Q000209:etiology* / Q000382:microbiology / Q000401:mortality*