Document 0393
 DOCN  M9590393
 TI    National trends in the concurrence of tuberculosis and acquired
       immunodeficiency syndrome.
 DT    9509
 AU    Burwen DR; Bloch AB; Griffin LD; Ciesielski CA; Stern HA; Onorato IM;
       Division of Tuberculosis Elimination, Centers for Disease Control; and
       Prevention, Atlanta, Ga., USA.
 SO    Arch Intern Med. 1995 Jun 26;155(12):1281-6. Unique Identifier :
       AIDSLINE MED/95297889
 AB    BACKGROUND: Elucidation of the relationship between tuberculosis (TB)
       and the acquired immunodeficiency syndrome (AIDS) is needed to help
       predict the future course of these two epidemics. We examined nationwide
       trends in TB and AIDS occurring in the same individual. METHODS: Health
       departments in the 50 states, District of Columbia, Puerto Rico, and
       Guam matched their TB and AIDS case registries to determine the number
       of persons diagnosed with both TB and AIDS. The number of AIDS cases, TB
       cases, AIDS cases that matched with a TB case on the TB registry, and TB
       cases that matched with an AIDS case on the AIDS registry were reported
       to the Centers for Disease Control and Prevention, Atlanta, Ga. Data
       were analyzed for the period from 1981 through 1991. The number of
       matched TB-AIDS cases was compared with a modeled estimate of excess TB
       cases during the period from 1985 through 1990. RESULTS: From 1981
       through 1991 there were 11,299 AIDS cases that matched with a TB case on
       the TB registry, representing 5.1% (geographic variation, 0% to 9.3%) of
       AIDS cases. The TB cases that matched with an AIDS case on the AIDS
       registry represent 4.3% (geographic variation, 0% to 15.1%) of TB cases
       from 1981 through 1991. Since 1981, matched TB and AIDS cases increased
       yearly through 1990. When examined by year of AIDS report, the
       percentage of AIDS cases that matched with a TB case increased from 1981
       to 1982 (1.9% to 5.1%), remained fairly constant from 1983 through 1987
       (range, 4.0% to 4.7%), increased in 1988 (5.4%) after extrapulmonary TB
       was added to the AIDS case definition, and increased slightly through
       1990 (5.8%). When examined by year of TB report, the percentage of TB
       cases that matched with an AIDS case increased steadily from 1981
       through 1990 (0.1% to 9.5%). The calculated fraction of excess TB cases
       during the period from 1985 through 1990 that could be accounted for by
       identified TB-AIDS cases was 30%. CONCLUSION: The risk of TB or AIDS
       among persons already diagnosed with one disease is much higher than
       among the general population. The percentage of persons with TB who are
       also diagnosed with AIDS has been increasing rapidly. Human
       immunodeficiency virus-induced immunosuppression is an important
       contributor to the TB epidemic and probably accounts for a minimum of
       30% of excess TB cases during the period from 1985 through 1990.
 DE    Acquired Immunodeficiency Syndrome/*COMPLICATIONS/*EPIDEMIOLOGY
       AIDS-Related Opportunistic Infections/COMPLICATIONS/EPIDEMIOLOGY  Human
       Incidence  Population Surveillance  Registries  Tuberculosis,
       Pulmonary/*COMPLICATIONS/*EPIDEMIOLOGY  United States/EPIDEMIOLOGY
       JOURNAL ARTICLE

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