title: Tuberculosis and HIV co-infection in healthcare workers in England and Wales, 1999-2005.
abstract: This study used linked national tuberculosis (TB) and HIV surveillance data to investigate recent trends and factors associated with HIV co-infection (TB-HIV) in healthcare workers (HCWs) with TB in England and Wales. Methods applied were the χ2 trend test and logistic regression. Overall 14% (231/1627) of HCWs with TB were co-infected with HIV, increasing from 8% in 1999 to 14% in 2005 (P<0·001). Most (78%) HCWs were non-UK born and 74% of these developed TB ⩾2 years post-entry. Being born in Sub-Saharan Africa was an independent predictor for TB-HIV, especially for female HCWs (odds ratio 66·5, 95% confidence interval 16·3-271·1), who also had a lower median CD4 count than other co-infected women (106/mm3, interquartile range 40-200, P<0·01). Voluntary HIV testing of new HCWs should be encouraged as an opportunity for early diagnosis. Post-entry, a high index of clinical suspicion for TB in those most at risk remains important.
authors: Tuberculosis Section, Respiratory Diseases Department, Health Protection Agency, Colindale, London, UK. jpcrofts@hotmail.com
authors: J P
authors: JP
authors: Crofts
authors: M E
authors: ME
authors: Kruijshaar
authors: V
authors: V
authors: Delpech
authors: F
authors: F
authors: Ncube
authors: I
authors: I
authors: Abubakar
mesh_terms: D000328:Adult; D060085:Coinfection / Q000453:epidemiology*; D004739:England / Q000453:epidemiology; D005260:Female; D015658:HIV Infections / Q000150:complications* / Q000453:epidemiology*; D006282:Health Personnel; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D014376:Tuberculosis / Q000150:complications* / Q000453:epidemiology*; D014852:Wales / Q000453:epidemiology