HIV-INFECTION AND TUBERCULOSIS - AN EPIDEMIOLOGIC-STUDY FROM A FRENCHREGISTER

Setting: The possible impact of the human immunodeficiency virus (HIV) infection on the epidemiology of tuberculosis has never been studied in a general French population. Objective: To describe the evolution o f tuberculosis incidence from 1983 to 1991 in a French district (Rhone ) and to assess its relationships to HIV-related factors, and to deter mine the prevalence of HIV infection among adult tuberculosis patients registered from 1989 to 1991. Design: Information on sex, age, countr y of birth and the history and site of tuberculosis was derived from n otification forms, and information on HIV testing was collected especi ally for this study. Results: During these nine years, 2916 tuberculos is cases were registered. The incidence increased in 1991 after a slow decline in previous years. An analysis of the evolution in the distri bution of cases did not suggest any effect of HIV infection on the epi demiology of tuberculosis, with the exception of an increase in the pr oportion of patients originating from the Antilles and sub-Saharan Afr ica. The conservative estimate of prevalence of HIV infection was 9.8% in young adult patients. Conclusion: The overlap between the populati on with HIV infection and that with tuberculosis seems to be small and restricted to particularly vulnerable sub-groups of the population of this region.