Genitourinary tuberculosis in patients with HIV infection: Clinical features in an inner-city hospital population

Background: There has been a resurgence of tuberculosis (TB) in the United States, largely because of the HIV epidemic. The impact of this epidemic on the incidence and clinical presentation of genitourinary TB is largely unk nown. We describe the clinical findings and outcomes of genitourinary TB in patients infected with HIV and compare them with those in patients not inf ected with HIV. Methods: We retrospectively studied the case records of 16 patients infected with HIV and genitourinary TB and compared them with thos e of 8 patients without HIV infection diagnosed with genitourinary TB betwe en January 1, 1991, and December 31, 1997, at a large, urban, inner-city, t ertiary hospital. Data abstracted from records include demographics, sympto ms, signs, laboratory and radiologic findings, and in-hospital mortality. R esults: Of 1282 patients with tuberculosis, 24 patients had positive urine cultures for Mycobacterium tuberculosis. HIV infection was present in 16 pa tients (75%). Patients infected with HIV were younger (mean age, 39.1 +/- 6 .2 versus 53.9 +/- 17.2, P = 0.047) but did not differ significantly in cli nical presentation from patients who did not have HIV infection. The combin ed mortality rate was 16.7%. Advanced age was the strongest predictor of po or outcome (P = 0.03). Conclusions: HIV infection was present in 66.7% of p atients with genitourinary TB seen an inner-city hospital. Increasing age w as associated with poor survival. No significant differences in clinical pr esentation nor in-hospital mortality were observed between those with HIV i nfection and those without HIV infection.