SETTING: The tuberculosis (TB) service responsible for all TB treatment in Harare, Zimbabwe. OBJECTIVES: (1) To determine HIV seroprevalence among TB patients and controls. (2) To compare clinical and demographic characteristics of HIV-infected and uninfected TB patients. DESIGN: Cohort study. Entry criterion: TB diagnosed during the 18 month study period. Assessment included HIV serology. Matched community controls were HIV serotested. RESULTS: In 1434 TB patients tested, HIV seroprevalence was 48% in men and 44% in women, peaked in the 25-34 year age group and was higher than in controls (relative risk [RR] = 3.1, 95% confidence interval [CI] = 2.6-3.7). In adults, seroprevalence was 34%, 49% and 58% in successive 6 month periods. A history of entry of prior TB treatment was less common in the HIV-seropositive (RR = 0.57, CI = 0.37-0.88). In adults, tuberculin negativity, TB at 2 sites, lymph node, pericardial and miliary TB, hilar adenopathy and pleural effusion were significantly more common in HIV-seropositive patients; cavitation and upper lobe involvement were significantly less frequent. Pulmonary TB and sputum smear positivity had similar frequencies in the 2 groups. CONCLUSION: HIV was strongly and increasingly associated with TB in Harare and altered the clinical and radiologic features of TB. Failed standard TB treatment in HIV-infected individuals contributed minimally to new cases of TB.
SETTING: The tuberculosis (TB) service responsible for all TB treatment in Harare, Zimbabwe. OBJECTIVES: (1) To determine HIV seroprevalence among TB patients and controls. (2) To compare clinical and demographic characteristics of HIV-infected and uninfected TB patients. DESIGN: Cohort study. Entry criterion: TB diagnosed during the 18 month study period. Assessment included HIV serology. Matched community controls were HIV serotested. RESULTS: In 1434 TB patients tested, HIV seroprevalence was 48% in men and 44% in women, peaked in the 25-34 year age group and was higher than in controls (relative risk [RR] = 3.1, 95% confidence interval [CI] = 2.6-3.7). In adults, seroprevalence was 34%, 49% and 58% in successive 6 month periods. A history of entry of prior TB treatment was less common in the HIV-seropositive (RR = 0.57, CI = 0.37-0.88). In adults, tuberculin negativity, TB at 2 sites, lymph node, pericardial and miliary TB, hilar adenopathy and pleural effusion were significantly more common in HIV-seropositivepatients; cavitation and upper lobe involvement were significantly less frequent. Pulmonary TB and sputum smear positivity had similar frequencies in the 2 groups. CONCLUSION: HIV was strongly and increasingly associated with TB in Harare and altered the clinical and radiologic features of TB. Failed standard TB treatment in HIV-infected individuals contributed minimally to new cases of TB.
Entities:
Keywords:
Africa; Africa South Of The Sahara; Biology; Clinical Research; Cohort Analysis; Developing Countries; Diseases; Eastern Africa; English Speaking Africa; Hiv Infections; Infections; Measurement; Physiology; Prevalence; Pulmonary Effects; Research Report; Tuberculosis; Viral Diseases; Zimbabwe
Authors: R S Heyderman; M Goyal; P Roberts; S Ushewokunze; S Zizhou; B G Marshall; R Makombe; J D Van Embden; P R Mason; R J Shaw Journal: Thorax Date: 1998-05 Impact factor: 9.139