HIV and tuberculosis co-infection in an inner London hospital - a prospective anonymized seroprevalence study

Objectives: since 1987 there has been an increase in tuberculosis notificat ions in the U.K., with this increase disproportionately affecting London. a recent national survey suggests that co-infection with HIV occurs in less than 5% of tuberculosis patients. This study asked if local co-infection ra tes in Inner London differed from the national results. Methods: 157 consecutive patients starting antituberculous chemotherapy wer e venesected 2 weeks into treatment. Anonymized blood samples were screened for antibodies for HIV-1 and HIV-2 by enzyme-linked immunosorbent assay (E LISA). Epidemiological data were collected on each patient which was also c oded before HIV test results were known. Results: of 157 patients commencing antituberculous therapy, 39 patients (2 4.8%) were found to be co-infected with HIV-1. HIV-negative and positive pa tients were similar in terms of age and sex.. When 98 patients giving their country of origin as other than Europe were considered there were 22 co-in fected with HIV (22.4%). Of the 39 HIV-positive identified in this study, 3 7 were also identified by our voluntary HIV testing programme. Conclusions: this study has shown that there may be very different rates of co-infection at a local level in the U.K. The local variation may be misse d by national surveys and diverse local testing procedures. Anonymous testi ng identified only two patients with tuberculosis and HIV infection who wer e not identified by our-voluntary HIV testing programme and this suggests t hat offering HIV tests to patients with tuberculosis is largely taken up by those at risk of HIV infection, Surveillance studies of this type are impo rtant in identifying marked local variation from the national pattern of HI V and Mycobacterium tuberculosis infection.