title: Tuberculosis and HIV co-infection, California, USA, 1993–2008.
abstract: To understand the epidemiology of tuberculosis (TB) and HIV co-infection in California, we cross-matched incident TB cases reported to state surveillance systems during 1993–2008 with cases in the state HIV/AIDS registry. Of 57,527 TB case-patients, 3,904 (7%) had known HIV infection. TB rates for persons with HIV declined from 437 to 126 cases/100,000 persons during 1993–2008; rates were highest for Hispanics (225/100,000) and Blacks (148/100,000). Patients co-infected with TB–HIV during 2001–2008 were significantly more likely than those infected before highly active antiretroviral therapy became available to be foreign born, Hispanic, or Asian/Pacific Islander and to have pyrazinamide-monoresistant TB. Death rates decreased after highly active antiretroviral therapy became available but remained twice that for TB patients without HIV infection and higher for women. In California, HIV-associated TB has concentrated among persons from low- and middle-income countries who often acquire HIV infection in the peri-immigration period.
authors.affiliation: University of California, San Francisco, CA, USA.
authors.forename: John Z
authors.initials: JZ
authors.lastname: Metcalfe
authors.forename: Travis C
authors.initials: TC
authors.lastname: Porco
authors.forename: Janice
authors.initials: J
authors.lastname: Westenhouse
authors.forename: Mark
authors.initials: M
authors.lastname: Damesyn
authors.forename: Matt
authors.initials: M
authors.lastname: Facer
authors.forename: Julia
authors.initials: J
authors.lastname: Hill
authors.forename: Qiang
authors.initials: Q
authors.lastname: Xia
authors.forename: James P
authors.initials: JP
authors.lastname: Watt
authors.forename: Philip C
authors.initials: PC
authors.lastname: Hopewell
authors.forename: Jennifer
authors.initials: J
authors.lastname: Flood
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D023241:Antiretroviral Therapy, Highly Active; D002140:California / Q000453:epidemiology; D060085:Coinfection / Q000188:drug therapy / Q000453:epidemiology*; D062665:Epidemiological Monitoring; D005260:Female; D015658:HIV Infections / Q000188:drug therapy / Q000453:epidemiology*; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012189:Retrospective Studies; D014397:Tuberculosis, Pulmonary / Q000453:epidemiology*; D055815:Young Adult