FACTORS ASSOCIATED WITH EXTRAPULMONARY TUBERCULOSIS AS AN AIDS-DEFINING DISEASE IN EUROPE

Setting: Western Europe: 8 countries and the city of Amsterdam. Object ive: To identify factors associated with extrapulmonary tuberculosis ( EPTB) at AIDS diagnosis among adult AIDS patients. Design: The proport ion of AIDS cases diagnosed between January 1988 and June 1992 with EP TB was analysed by age, gender, year of diagnosis, country and HIV tra nsmission category. Multiple logistic regression was performed separat ely for patients infected through heterosexual contact who were likely to originate from Africa or the Caribbean (heterosexual subgroup 1), and for other patients. Results: The overall proportion with EPTB was 4.6% and remained stable between 1988 and 1992. It differed significan tly by country (from 2.4% in the United Kingdom to 24.7% in Portugal) and by transmission category (2.7% among homo/bisexuals, 5.8% among in jecting drug users, 13.6% among heterosexual subgroup 1). In multivari ate analysis, the risk of EPTB was independently associated with young er age and mate gender. Among patients other than from heterosexual su bgroup 1, country and transmission category were also independent pred ictors of EPTB at AIDS diagnosis. Conclusion: The risk of presenting E PTB as an AIDS-defining disease is not homogeneous within Europe. Resu lts suggest an increased risk of tuberculosis in specific groups of HI V-infected persons (persons originating from sub-Saharan Africa, injec ting drug users) and a potential role of recent Mycobacterium tubercul osis infection among younger patients.