Sarah Goodwin

Kathi Ovnic
Holly Korschun
June 30, 1998

GENEVA, SWITZERLAND--A large percentage of tuberculosis patients who were HIV positive before developing TB only find out about their HIV status when they are diagnosed with active TB, and another substantial number of HIV-positive patients contract tuberculosis partly because they fail to obtain available prophylactic care after their HIV diagnosis.

These findings, presented at the 12th World AIDS Congress in Geneva this week, are the result of a study of inner-city tuberculosis patients conducted by Emory University School of Medicine and Grady Memorial Hospital physician-researchers Robert Horsburgh, Jr., Mark J. Sotir, Jeffrey L. Lennox, P.P. Moore, and Henry M. Blumberg.

The researchers recorded cases of all patients with tuberculosis diagnosed between 1991 and 1996 at Grady Memorial Hospital in Atlanta. Of the 1,203 patients identified with TB, 493 (41%) were HIV-infected. From 1994 to 1996, 118 patients with both TB and HIV were identified, with 124 hospital admissions. Of this group, 48 (41%) were diagnosed with HIV at the same time that they were diagnosed with active TB. Of the 70 patients who knew their HIV status before they developed active TB, only 14 (20%) had attended the HIV clinic before their TB diagnosis was made.

"These patients often do not feel sick when they are first diagnosed with HIV," explains Dr. Horsburgh. "The treatment regimens are complex and not always affordable."

Three-hundred eighty (77%) of the patients with both HIV and tuberculosis were male; 440 (89%) were black. Median age of the patients was 35. Although the number of new patients with tuberculosis declined from 255 in 1990 to 175 in 1996, the percentage of patients with both TB and HIV did not change significantly over time.

The research was supported the the Georgia Department of Human Resources, Division of Public Health and the National Institutes of Health.

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