Risk factors for tuberculosis among human immunodeficiency virus-infected persons. A case-control study in Belo Horizonte, Minas Gerais, Brazil (1985-1996)

The objective of this study was to identify tuberculosis risk factors and p ossible surrogate markers among human immunodeficiency virus (HIV)infected persons. A retrospective case-control study was carried out at the HIV outp atient clinic of the Universidade Federal de Minas Gerais in Belo Horizonte . We reviewed the demographic, social-economical and medical data of 477 HI V-infected individuals evaluated from 1985 to 1996. The variables were subm itted to an univariate and stratified analysis. Aids related complex (ARC), past history of pneumonia, past history of hospitalization, CD4 count and no antiretroviral use were identified as possible effect modifiers and conf ounding variables, and were submitted to logistic regression analysis by th e stepwise method. ARC had an odds ratio (OR) of 3.5 (CI 95% - 1.2-10.8) fo r tuberculosis development. Past history of pneumonia (OR 1.7 - CI 95% 0.6- 5.2) and the CD4 count (OR 0.4 - CI 0.2-1.2) had no statistical significanc e. These results show that ARC is an important clinical surrogate for tuber culosis in HIV-infected patients. Despite the need of confirmation in futur e studies, these results suggest that the ideal moment for tuberculosis che moprophylaxis could be previous to the introduction of antiretroviral treat ment or even just after the diagnosis of HIV infection.