AEGiS-13IAC: Self-reported TB testing and treatment in an HIV-infected population: Results from an interview project in the United States.

13th International AIDS Conference

Durban, South Africa - July 9-July 14, 2000

Self-reported TB testing and treatment in an HIV-infected population: Results from an interview project in the United States.

Int Conf AIDS 2000 Jul 9-14; 13:(abstract no. MoOrC191)

Campsmith M, Nakashima AK, Fleming PL, Burgess DA
M. Campsmith, Centers for Disease Control & Prevention, 1600 Clifton Road, NE Mailstop E-47, Atlanta, Georgia 30333, United States, Tel.: +1 404 639 51 74, Fax: +1 404 639 29 80, E-mail: mgc4@cdc.gov

BACKGROUND: Persons with HIV are at higher risk for tuberculosis (TB); co-infection can affect the clinical outcomes of both diseases. In 1989, the U.S. Advisory Committee for the Elimination of Tuberculosis recommended that all persons infected with HIV be tested for TB, with appropriate therapy for those having a positive TB skin test.

OBJECTIVE: To describe TB testing and treatment in an HIV-infected population.

METHODS: Analysis of cross-sectional interviews with subjects é 18 years of age reported with HIV or AIDS to 12 state and local health departments from January 1995 through June 1999. Persons who ever had active TB were excluded from analysis.

RESULTS: Although 90% of 10,783 persons reported ever having a TB skin test (PPD), only 81% had received a PPD since HIV diagnosis. PPD testing was lowest in the first year after HIV diagnosis (72%) but significantly increased over time (chi square test for trend P > .001). 8% (366 of 4,431 for whom information was known) of those TB skin tested after HIV diagnosis were PPD+; of this group, 27% had never taken TB medication, 12% had previously taken TB medication, and 61% started TB medication after HIV diagnosis. Persons whose main source of HIV care was a public clinic were more likely to have had a PPD test since HIV diagnosis (5,433/6,509, 83%) compared to persons treated in private care settings (1,975/2,577, 77%) or those with no current source of HIV care (766/1,057, 72%), regardless of disease status (HIV or AIDS). PPD+ public care patients were also more likely to have been prescribed TB medication (147/222, 66%; 26/57, 47%; and 17/32, 53%, respectively).

CONCLUSION: Despite recommendations, a sizeable proportion of HIV-infected persons without a history of active TB had not received a TB skin test or TB treatment since HIV diagnosis. A concerted effort is needed to implement comprehensive PPD testing and appropriate TB therapy for all HIV-infected persons.

Keywords: AEGIS, HIV Infections, Interviews, HIV Seropositivity, Tuberculosis, Acquired Immunodeficiency Syndrome, Tuberculin Test, Research Design, United States, Population, Antiretroviral Therapy, Highly Active, Greece, Human, therapy, methods, drug therapy
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MoOrC191