Am. J. Respir. Crit. Care Med., Vol 153, No. 4, 04 1996, 1448-1450.
Testing for human immunodeficiency virus infection in patients with tuberculosis
PF Barnes, C Silva and M Otaya
Department of Medicine, University of Southern California School of Medicine, Los Angeles, USA.
To investigate the utility of testing all tuberculosis patients for HIV
infection in Los Angeles, we prospectively evaluated 183 hospitalized
patients with acid-fast smear-positive tuberculosis who gave no history of
HIV infection. HIV serologic testing was performed, and the presence of
risk factors for HIV infection was assessed by interview and review of the
medical record. Thirty-three patients (18%) were infected with HIV. Based
on data obtained by interview, 124 (68%) of 183 patients had at least one
risk factor for HIV infection. The most common risk factors were related to
heterosexual transmission of HIV (prostitute contact, multiple sex
partners, and a history of sexually transmitted disease). These risk
factors were frequently not documented in the medical record. Among the 33
patients who were infected with HIV, 30 were identified by interviewing as
having significant risk factors. We concluded that most tuberculosis
patients in Los Angeles have risk factors for HIV infection and that
systematic questioning does not identify risk factors in all HIV-infected
tuberculosis patients. These data support current recommendations to screen
all tuberculosis patients for HIV infection.
