Snr. Gampper et al., COINFECTION WITH MYCOBACTERIUM-TUBERCULOSIS AND HIV IN HIGH-RISK CLINICAL CARE SETTINGS IN RHODE-ISLAND, AIDS care, 10(2), 1998, pp. 221-229
We assessed the extent to which co-infection with HIV and Mycobacteriu
m tuberculosis (Mtb) was diagnosed at several high risk clinical care
sites from 1992 to 1994 to determine whether surveillance for co-infec
tion was performed. Information on PPD skin testing, HIV status, and H
IV risk exposures was extracted from records at HIV clinics in Rhode I
sland and a large database (HIV sites) and from records at the state T
B clinic and the Rhode bland Health Department (TB sites). At the HIV
sites, 34 of 1,408 HIV infected subjects were newly diagnosed with Mtb
infection in the study period. At the TB sites, 16 of 1,389 subjects
with newly diagnosed Mtb infection or disease were identified as HIV i
nfected Eighty per cent of the records reviewed for this study were in
complete. Hispanic subjects were at higher risk of being identified as
co-infected at the HIV sites. At the TB sites, US-born subjects were
at higher risk of being identified as co-infected. Recommendations for
high risk individuals include yearly tuberculosis skin testing. Adher
ence to these guidelines in selected high-risk clinical care sites in
Rhode Island was substandard during the study period; the importance o
f Mtb screening was demonstrated in this study. Identification of grou
ps that are at higher risk of having HIV and Mtb co-infection identifi
ed may enable health care providers to improve testing and prevention
of tuberculosis at high risk clinical care settings.