BACKGROUND: The increasing global burden of tuberculosis (TB) is linked to human immunodeficiency virus (HIV) infection. METHODS: We reviewed data from notifications of TB cases, cohort treatment outcomes, surveys of Mycobacterium tuberculosis infection, and HIV prevalence in patients with TB and other subgroups. Information was collated from published literature and databases held by the World Health Organization (WHO), the Joint United Nations Programme on HIV/Acquired Immunodeficiency Syndrome (UNAIDS), the US Census Bureau, and the US Centers for Disease Control and Prevention. RESULTS: There were an estimated 8.3 million (5th-95th centiles, 7.3-9.2 million) new TB cases in 2000 (137/100,000 population; range, 121/100,000-151/100,000). Tuberculosis incidence rates were highest in the WHO African Region (290/100,000 per year; range, 265/100,000-331/100,000), as was the annual rate of increase in the number of cases (6%). Nine percent (7%-12%) of all new TB cases in adults (aged 15-49 years) were attributable to HIV infection, but the proportion was much greater in the WHO African Region (31%) and some industrialized countries, notably the United States (26%). There were an estimated 1.8 million (5th-95th centiles, 1.6-2.2 million) deaths from TB, of which 12% (226 000) were attributable to HIV. Tuberculosis was the cause of 11% of all adult AIDS deaths. The prevalence of M tuberculosis-HIV coinfection in adults was 0.36% (11 million people). Coinfection prevalence rates equaled or exceeded 5% in 8 African countries. In South Africa alone there were 2 million coinfected adults. CONCLUSIONS: The HIV pandemic presents a massive challenge to global TB control. The prevention of HIV and TB, the extension of WHO DOTS programs, and a focused effort to control HIV-related TB in areas of high HIV prevalence are matters of great urgency.

https://jamanetwork.com/journals/jamainternalmedicine/articlepdf/215525/ira20017.pdf

The growing burden of tuberculosis: global trends and interactions with the HIV epidemic.

BACKGROUND
The increasing global burden of tuberculosis (TB) is linked to human immunodeficiency virus (HIV) infection.


METHODS
We reviewed data from notifications of TB cases, cohort treatment outcomes, surveys of Mycobacterium tuberculosis infection, and HIV prevalence in patients with TB and other subgroups. Information was collated from published literature and databases held by the World Health Organization (WHO), the Joint United Nations Programme on HIV/Acquired Immunodeficiency Syndrome (UNAIDS), the US Census Bureau, and the US Centers for Disease Control and Prevention.


RESULTS
There were an estimated 8.3 million (5th-95th centiles, 7.3-9.2 million) new TB cases in 2000 (137/100,000 population; range, 121/100,000-151/100,000). Tuberculosis incidence rates were highest in the WHO African Region (290/100,000 per year; range, 265/100,000-331/100,000), as was the annual rate of increase in the number of cases (6%). Nine percent (7%-12%) of all new TB cases in adults (aged 15-49 years) were attributable to HIV infection, but the proportion was much greater in the WHO African Region (31%) and some industrialized countries, notably the United States (26%). There were an estimated 1.8 million (5th-95th centiles, 1.6-2.2 million) deaths from TB, of which 12% (226 000) were attributable to HIV. Tuberculosis was the cause of 11% of all adult AIDS deaths. The prevalence of M tuberculosis-HIV coinfection in adults was 0.36% (11 million people). Coinfection prevalence rates equaled or exceeded 5% in 8 African countries. In South Africa alone there were 2 million coinfected adults.


CONCLUSIONS
The HIV pandemic presents a massive challenge to global TB control. The prevention of HIV and TB, the extension of WHO DOTS programs, and a focused effort to control HIV-related TB in areas of high HIV prevalence are matters of great urgency.

Global Trends and Interactions With the HIV Epidemic

Tattooing and body piercing among adolescent detainees: relationship to alcohol and other drug use.

BACKGROUND: Previous studies have estimated the prevalence of tuberculosis and HIV infection in population subgroups in the UK. This study was undertaken to describe recent trends in the proportion of individuals with HIV infection among reported cases of tuberculosis in England and Wales, and to review the implications for clinical and public health care. METHODS: A population-based matching study using national surveillance databases was used to investigate all persons aged 15 years and over reported with a diagnosis of tuberculosis to the Health Protection Agency in England and Wales in 1999-2003. Record linkage was used to match the national tuberculosis and HIV/AIDS surveillance databases to identify all cases of tuberculosis and determine the proportion of patients with tuberculosis co-infected with HIV. The distribution and characteristics of the cases were determined and the trend examined by year. RESULTS: Of 30,670 cases of tuberculosis reported in England and Wales between 1999 and 2003, an estimated 1743 (5.7%) were co-infected with HIV. There was a year on year increase in the proportion from 3.1% (169/5388) in 1999 to 8.3% (548/6584) in 2003 (p for trend <0.0001). Co-infected patients contributed to almost a third of the increase in the number of cases of tuberculosis during the 5 year period. Patients co-infected with HIV were predominantly those born abroad. 18.5% (n = 323) of co-infected patients had not been reported as active cases of tuberculosis on the national tuberculosis database. CONCLUSION: The proportion of patients with tuberculosis co-infected with HIV in England and Wales is increasing, with the greatest impact on those born abroad regardless of their ethnic origin. With HIV infection contributing substantially to the increase in the number of cases of tuberculosis, close cooperation in the clinical management and accurate notification of patients is vital if appropriate care and public health action is to be achieved.

https://thorax.bmj.com/content/thoraxjnl/62/8/672.full.pdf

The growing impact of HIV infection on the epidemiology of tuberculosis in England and Wales: 1999–2003

Tuberculosis remains predominantly a disease of the disadvantaged and marginalized. The incidence of the disease is increasing in many industrially developed countries, particularly among the poor, ethnic minorities, prisoners and other institutionalized persons, and the socially isolated and hard to reach groups. Strengthening of the tuberculosis services is required to care for these groups. Millions of people in the developing nations are disadvantaged by poverty and inequity, and recent health sector reforms have not always been entirely in their interest. A further serious problem is the HIV/AIDS pandemic, which not only facilitates the spread of tuberculosis but, by its associated stigma, leads to delayed treatment seeking and poor adherence to therapy. In recent times, emphasis has moved away from didactic principles of tuberculosis "control" to community-and patient-centered health services, based on analysis of local factors affecting case finding and adherence to therapy.

Tuberculosis in disadvantaged groups.

CONTEXTE : Les drogues par voie intraveineuse (IDU) et les prisonniers sont des groupes d'un grand interet epidemiologique en ce qui concerne l'infection par le virus de l'immunodeficience humaine (VIH) OBJECTIF: Determiner les facteurs predictifs et les tendances evolutives de la co-infection de Mycobacterium tuberculosis et VIH chez les IDU lors de l'incarceration PATIENTS ET METHODES : Entre le 1er janvier 1991 et le 31 decembre 1997, on a etudie chez 796 IDU ou anciens IDU les variables socio-demographiques et penitentiaires Les sujets seropositifs pour le VIH dont le test tuberculinique montrait une induration de 5 mm ou davantage ont ete consideres comme co-infectes, l'analyse des facteurs associes a la co-infection s'est fondee sur un modele de regression logistique RESULTATS : Lors de l'incarceration, 44,0% des prisonniers sont infectes par M tuberculosis, 43,8% par le VIH et 20,1% sont co-infectes Les predicteurs de la co-infection sont: 1) duree totale d'incarceration subie anterieurement (aucune, OR 1 ; 29 ans, OR 3,67, IC95% 1,96-6,86); 3) les tatouages (OR 1,56, IC95% 0,98-2,49); 4) l'echange de seringues (OR 2,43, IC95% 1,57-3,77) et 5) un statut d'anciens IDUs (OR 1,87, IC95% 1,23-2,82) On n'a observe aucune variation statistiquement significative dans la tendance a la co-infection au fil des annees (OR 1,10, IC95% 0,98-1,22) CONCLUSION: On a detecte une prevalence elevee de la co-infection liee a certains facteurs de risques, ameliorables par une intervention de sante publique

Mycobacterium tuberculosis and human immunodeficiency virus co-infection in intravenous drug users on admission to prison.

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Mycobacterium tuberculosis and human immunodeficiency virus co-infection in intravenous drug users on admission to prison.