Transmission trends for human immunodeficiency virus associated tuberculosis in New York City
Abstract:SETTING: Since 1992, tuberculosis (TB) control measures have reduced incidence rates in New York City and elsewhere. Nevertheless, trends have not been uniform in all demographic groups.
OBJECTIVE: To characterize the epidemiology of human immunodeficiency virus (HIV) associated TB in New York during the 1990s, we analyzed social, demographic and clinical characteristics and genetic data on Mycobacterium tuberculosis isolates among persons with known HIV-status.
DESIGN: A retrospective case-control study to compare patients with HIV-associated TB and patients with TB alone.
RESULTS: Of 546 patients (70.5%) in the Department of Health Tuberculosis Control Registry treated for TB, 385 also had documented HIV status; 198 were HIV-infected (51%) and 187 (49%) were not. Genotype analysis of the 385 M. tuberculosis isolates identified 200 (52%) clustered strains, representing recent transmission. Although the overall percentage of TB cases associated with restriction fragment length polymorphism (RFLP) clustering fell over the period studied, HIV-associated cases were still much more likely to be associated with clustering than non-HIV-associated cases.
CONCLUSIONS: Continued attention is required to contain the spread of TB in this vulnerable population.
Document Type: Regular Paper
Affiliations: 1: Department of Medicine, Columbia University College of Physicians and Surgeons, New York, New York, USA 2: Public Health Research Institute, Newark, New Jersey, USA 3: TB Control Program, New York City Department of Health, New York, USA 4: Department of Medicine, Columbia University College of Physicians and Surgeons, New York, New York, USA; and Department of Epidemiology, Columbia University Mailman School of Public Health, New York, New York, USA
Publication date: June 1, 2005
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