title: HIV-associated tuberculosis in Auckland.
abstract: OBJECTIVE
  New Zealand has low rates of disease caused by to Mycobacterium tuberculosis (TB) and Human Immunodeficiency Virus (HIV). This study is the first to describe a New Zealand cohort of patients with HIV-associated TB.
  
  
  METHODS
  We retrospectively reviewed the clinical records, laboratory data and chest radiographs of all patients who were diagnosed with HIV-associated TB and who commenced treatment for TB disease at Auckland City Hospital between January 1997 and July 2009.
  
  
  RESULTS
  During the 12-and-a-half year study period, 40 patients were diagnosed with HIV-associated TB. The median age was 37 years and the median CD4 count was 130 cells/mm3. Only 2 patients were New Zealand born. Twenty-four (60%) patients had known HIV infection prior to their diagnosis of TB disease. Two patients with known HIV infection and positive tuberculin skin tests had not received treatment for latent tuberculosis infection (LTBI). Twenty-three (58%) patients received antiretroviral treatment during their TB treatment. There were 21 episodes of treatment interruption or immune reconstitution inflammatory syndrome. Three (8%) patients died.
  
  
  CONCLUSIONS
  New Zealand continues to have a low incidence of HIV-associated TB. Early HIV diagnosis with universal screening and the treatment of LTBI in persons living with HIV infection is key to minimising the disease burden.
authors.affiliation: General medical and Infectious Diseases Physician, Middlemore Hospital, 100 Hospital Road, Papatoetoe, Auckland, New Zealand 2025. christopher.luey@middlemore.co.nz.
authors.forename: Christopher
authors.initials: C
authors.lastname: Luey
authors.forename: David
authors.initials: D
authors.lastname: Milne
authors.forename: Simon
authors.initials: S
authors.lastname: Briggs
authors.forename: Mark
authors.initials: M
authors.lastname: Thomas
authors.forename: Rupert
authors.initials: R
authors.lastname: Handy
authors.forename: Mitzi
authors.initials: M
authors.lastname: Nisbet
mesh_terms: D000328:Adult; D023241:Antiretroviral Therapy, Highly Active; D000995:Antitubercular Agents / Q000627:therapeutic use; D060085:Coinfection / Q000453:epidemiology; D005260:Female; D015658:HIV Infections / Q000188:drug therapy / Q000453:epidemiology*; D006801:Humans; D054019:Immune Reconstitution Inflammatory Syndrome / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009520:New Zealand / Q000453:epidemiology; D014376:Tuberculosis / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology; D014385:Tuberculosis, Gastrointestinal / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology*; D014388:Tuberculosis, Lymph Node / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology*; D014397:Tuberculosis, Pulmonary / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology*; D055815:Young Adult
chemical_list: D000995:Antitubercular Agents