title: Transmission of Mycobacterium tuberculosis to contacts of HIV-infected tuberculosis patients.
abstract: We assessed the infectiousness of human immunodeficiency virus (HIV)-seropositive and HIV-seronegative individuals with pulmonary tuberculosis (TB) in a prospective cohort study. We enrolled, evaluated, and followed 104 close contacts of HIV-seropositive pulmonary TB patients and 256 close contacts of HIV-seronegative pulmonary TB patients using a standardized questionnaire, symptom review, chest radiograph, HIV serology, and tuberculin skin testing (TST). Contacts were followed for > or = 12 mo. TB infection at enrollment was 27% (28/104) among contacts of HIV-seropositive TB patients and 35% (90/256) among contacts of HIV-seronegative TB patients (odds ratio [OR] = 0.68, 95% confidence interval [CI] 0.41 to 1.12; p = 0.130). TST conversion occurred in 21% (42/ 204) of subjects; 8% (5/63) of contacts of HIV-seropositive index cases and 26% (37/141) of contacts of HIV-seronegative index cases (OR = 0.24, 95% CI 0.09 to 0.65; p = 0.003). TB was diagnosed in nine contacts; eight were contacts of HIV-seronegative index cases. HIV seropositivity in the index case was independently associated with a lower risk of TB infection among contacts, even among household contacts younger than 15 yr of age. Contacts of HIV-seropositive persons with pulmonary TB were less likely to have a positive TST response at 1 yr of follow-up than contacts of HIV-seronegative persons.
authors.affiliation: Unidade de Pesquisa em Tuberculose, Serviço de Pneumologia, Hospital Universitário Clementino Fraga Filho/Universidade Federal do Rio de Janeiro (HUCFF/UFRJ), Rio de Janeiro, Brazil.
authors.forename: A C
authors.initials: AC
authors.lastname: Carvalho
authors.forename: K
authors.initials: K
authors.lastname: DeRiemer
authors.forename: Z B
authors.initials: ZB
authors.lastname: Nunes
authors.forename: M
authors.initials: M
authors.lastname: Martins
authors.forename: M
authors.initials: M
authors.lastname: Comelli
authors.forename: A
authors.initials: A
authors.lastname: Marinoni
authors.forename: A L
authors.initials: AL
authors.lastname: Kritski
mesh_terms: D017088:AIDS-Related Opportunistic Infections / Q000635:transmission*; D000293:Adolescent; D000328:Adult; D000704:Analysis of Variance; D002648:Child; D002675:Child, Preschool; D016001:Confidence Intervals; D005192:Family Health; D005260:Female; D018023:HIV Seronegativity; D006679:HIV Seropositivity; D006801:Humans; D016015:Logistic Models; D008297:Male; D016017:Odds Ratio; D012307:Risk Factors; D014397:Tuberculosis, Pulmonary / Q000635:transmission*