One-Third Of People With TB In US Unaware Of HIV Status

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Nearly one-third of people living with tuberculosis in the U.S. areunaware of their HIV status, according to a study published Friday in CDC's Morbidity and Mortality Weekly Report, Reuters reports (Dunham, Reuters, 10/25).

The study examined data from the National TB Surveillance Systemfrom 1993 to 2005 for 49 states and Washington, D.C. According to thestudy, reporting of HIV status among people living with TB increasedfrom 35% in 1993 to 68% in 2003 and leveled off during 2004 and 2005(Marks et al., MMWR, 10/26). Nine percent of all peoplewith active TB in the U.S. tested positive for HIV in 2005. Thirty-onepercent of those with TB were unaware of their HIV status in 2005because they refused testing or were not offered a test, compared with65% of people living with TB in 1993 (Reuters, 10/25).Groups of people living with TB at an increased risk of acquiring HIVinclude injection-drug users, noninjection-drug users, homeless people,non-Hispanic blacks, prison inmates and alcohol abusers, according tothe report (MMWR, 10/26).

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In addition, the reportnoted that nearly two-thirds of people living with both HIV and TB wereblack. One in six black TB patients was HIV-positive, compared with onein 20 HIV-positive white TB patients, the report said. "High rates ofboth HIV infection and TB disease among non-Hispanic blacks emphasizethe need in this population to prevent, diagnose early and provideaccess to care for both conditions," the report said.

Accordingto CDC epidemiologist and report author Suzanne Marks, "HIV increasesTB progression, and TB increases HIV progression." She added that thediseases "result in a synergy that can be deadly." The agencyrecommends routine HIV testing among all people living with TB,according to Reuters. People with HIV/TB coinfection arefive times more likely to die during TB treatment than patients who areHIV-negative, according to CDC. "Increased promotion of routine HIVtesting and rapid HIV tests might increase acceptability of testing,which would allow health care providers to know the HIV status of agreater percentage of TB patients and enable them to provide optimalcare," the report said.

According to CDC, 13,779 TB cases werereported in the U.S. in 2006 -- a decrease of 3% compared with 2005. Ofthe cases reported in 2006, 57% involved people born outside thecountry. There were 646 deaths from TB in the U.S. in 2005, CDC said (Reuters, 10/25).

Reprinted with permission from kaisernetwork.org. You can view theentire Kaiser DailyHIV/AIDS Report, search the archives, and sign up for email delivery at kaisernetwork.org/email . The Kaiser Daily HIV/AIDS Report ispublished for kaisernetwork.org, a free service of The Henry J. Kaiser FamilyFoundation.

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