The impact of human immunodeficiency virus type 1 on infectiousness of tuberculosis: a meta-analysis.
To assess if the relative infectiousness of patients with tuberculosis is enhanced by coinfection with human immunodeficiency virus type 1 (HIV-1), data from 6 studies of 1240 health care workers who had contact with tuberculosis patients were analyzed. Overall rates of tuberculin skin test conversion were similar regardless of HIV-1 positivity of tuberculosis patients (odds ratio [OR], 1.04; 95% confidence interval [CI], 0.23-1.84). However, when only 3 studies during nosocomial outbreaks of multidrug-resistant Mycobacterium tuberculosis were analyzed, rates of skin test conversion were higher among contacts of HIV-1-positive index cases (OR, 2.85; 95% CI, 1.85-3.85; P=.0002). A second meta-analysis included data from 11 studies of 10,714 household contacts of tuberculosis patients. Prevalence of both skin test positivity (OR, 0.45; 95% CI, 0.20-1.03) and active disease (OR, 1.17; 95% CI, 0.78-1.56) were similar regardless of HIV-1 positivity of index cases. These data suggest that tuberculosis patients with HIV-1 infection are not intrinsically more infectious to their contacts than are HIV-1-negative tuberculosis patients.
Cruciani
M
M
Department of Infectious Diseases, HIV Screening Center, Verona, Italy.
Malena
M
M
Bosco
O
O
Gatti
G
G
Serpelloni
G
G
D017088:AIDS-Related Opportunistic Infections / Q000150:complications / Q000175:diagnosis / Q000635:transmission*; D017714:Community-Acquired Infections / Q000175:diagnosis / Q000635:transmission; D015658:HIV Infections / Q000150:complications* / Q000453:epidemiology; D015497:HIV-1; D006801:Humans; D017758:Infectious Disease Transmission, Patient-to-Professional; D015995:Prevalence; D014374:Tuberculin Test; D014376:Tuberculosis / Q000150:complications / Q000175:diagnosis / Q000635:transmission*