TUBERCULOSIS IN AFRICAN-AMERICANS - CLINICAL CHARACTERISTICS AND OUTCOME

This study examined the clinical characteristics and outcome of pulmon ary tuberculosis in African Americans hospitalized in a teaching hospi tal in south-central Los Angeles from May 1992 through April 1994. The charts of 41 African Americans with culture-positive Mycobacterium tu berculosis were reviewed. Predisposing factors For pulmonary tuberculo sis were identified in nearly half of cases. Cough and Fever were the most common symptoms. Seventy-six percent had positive acid-fast bacil li (AFB) smears. Nine patients were human immunodeficiency virus (HIV) -positive, and 6 of 9 HIV-positive patients had positive AFB smears wh ereas 17 of 19 HIV-negative patients had positive AFB smears. Radiogra phic changes were not significantly different between HIV-positive and HIV-negative patients. Drug resistance was identified in nine of 31 p atients (29%). Eight of 41 patients (19.5%) died, with 2 being drug re sistant. Human immunodeficiency virus infection was a major predisposi ng Factor for tuberculosis, and no statistical differences were found in radiographic Features or AFB smear positivity between HIV-positive and HIV-negative patients. Drug resistance and mortality were dispropo rtionately high. These results indicate that HIV infection and drug re sistance are major problems that predispose for tuberculosis infection and make its treatment difficult.