Human Immunodeficiency Virus Infection in Tuberculosis Patients

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Abstract
Human immunodeficiency virus (HIV) serologywas performed in non-Asian-bom patients 18–65 years old with newly diagnosed tuberculosis at a county tuberculosis clinic, and demographic and clinical features of HIV-seropositive and HIV-seronegative patients were compared. Sixty of 128 eligible patients agreed to participate, of whom 17 (28%) were seropositive. Risk of HIV was associated with homosexual contact, intravenous drug use, or both; however, 4 (24%) of the 17 seropositives denied risk behaviors. Significantly more blacks (48%) than whites (10%) or Latinos (20%) were HIV-seropositive (P < .01). Site of disease, tuberculin reactivity, response to therapy, drug toxicity, and relapse did not differ significantly between groups. HIV-seropositive patients had significantly lower median CD4+ cell counts (326/mm3, range 23–742/mm3 , vs. 929/mm3 , range 145–2962/mm3, P < .0005) and median CD4+:CD8+ ratios (0.50, range 0.14–1.07 vs. 1.54, range 0.35–4.36, P < .0001). HIV infection is associated with clinically typical tuberculosis and HIV screening of tuberculosis patients is recommended in areas where HIV is endemic.