HIV testing among tuberculosis patients in the era of antiretroviral therapy

A population-based study in Brazil

K. DeRiemer, E. C C Soares, S. M O Dias, S. C. Cavalcante

Research output: Contribution to journalArticle

16 Citations (Scopus)

Abstract

SETTING: Rio de Janeiro, Brazil, a city with 29 862 cases of tuberculosis (TB) reported between January 1995 and June 1998. OBJECTIVES: To evaluate the counseling and testing practices for human immunodeficiency virus (HIV) infection among TB patients, and to identify the patient characteristics associated with HIV screening as antiretroviral therapy was introduced. DESIGN: Cross-sectional study of patients with TB who were reported to the health department and who initiated anti-TB treatment. The main outcome measure was screened versus not screened for HIV. RESULTS: The proportion of TB patients who received HIV screening increased from January 1995 through June 1998 (P < 0.001). Among young adults aged 20-49 years with TB, the independent predictors of HIV screening were a diagnosis of both pulmonary and extra- pulmonary TB (odds ratio [OR] = 2.4, 95% confidence interval [CI] 2.1-2.8); TB meningitis (OR = 13.5, 95%CI 6.5-31.5); disseminated TB (OR = 8.2, 95%CI 5.3-12.9); lymphatic TB (OR = 5.6, 95%CI 4.7-6.6); and male sex [OR = 1.4, 95%CI 1.3-1.6). Patients with newly diagnosed TB who were women, lived in a low income neighborhood (OR = 0.7, 95%CI, 0.6-0.7), and sought TB treatment in their own residential neighborhood (OR = 0.3, 95%CI 0.3-0.4) were less likely to receive HIV counseling and testing. CONCLUSION: Health care providers in Rio de Janeiro selectively offered HIV counseling and testing to persons they perceived to be at risk for HIV and those with advanced stages of TB. HIV counseling and testing should be expanded and offered to all TB patients.

Original languageEnglish (US)
Pages (from-to)519-527
Number of pages9
JournalInternational Journal of Tuberculosis and Lung Disease
Volume4
Issue number6
StatePublished - Jun 2000

Fingerprint

Brazil
Tuberculosis
HIV
Population
Odds Ratio
Confidence Intervals
Counseling
Therapeutics
Meningeal Tuberculosis
Sex Ratio
Virus Diseases
Pulmonary Tuberculosis
Health Personnel
Young Adult
Cross-Sectional Studies
Outcome Assessment (Health Care)
Lung
Health

Keywords

  • Antiretroviral therapy
  • HIV counseling and testing
  • Surveillance
  • TB

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine

Cite this

HIV testing among tuberculosis patients in the era of antiretroviral therapy : A population-based study in Brazil. / DeRiemer, K.; Soares, E. C C; Dias, S. M O; Cavalcante, S. C.

In: International Journal of Tuberculosis and Lung Disease, Vol. 4, No. 6, 06.2000, p. 519-527.

Research output: Contribution to journalArticle

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abstract = "SETTING: Rio de Janeiro, Brazil, a city with 29 862 cases of tuberculosis (TB) reported between January 1995 and June 1998. OBJECTIVES: To evaluate the counseling and testing practices for human immunodeficiency virus (HIV) infection among TB patients, and to identify the patient characteristics associated with HIV screening as antiretroviral therapy was introduced. DESIGN: Cross-sectional study of patients with TB who were reported to the health department and who initiated anti-TB treatment. The main outcome measure was screened versus not screened for HIV. RESULTS: The proportion of TB patients who received HIV screening increased from January 1995 through June 1998 (P < 0.001). Among young adults aged 20-49 years with TB, the independent predictors of HIV screening were a diagnosis of both pulmonary and extra- pulmonary TB (odds ratio [OR] = 2.4, 95{\%} confidence interval [CI] 2.1-2.8); TB meningitis (OR = 13.5, 95{\%}CI 6.5-31.5); disseminated TB (OR = 8.2, 95{\%}CI 5.3-12.9); lymphatic TB (OR = 5.6, 95{\%}CI 4.7-6.6); and male sex [OR = 1.4, 95{\%}CI 1.3-1.6). Patients with newly diagnosed TB who were women, lived in a low income neighborhood (OR = 0.7, 95{\%}CI, 0.6-0.7), and sought TB treatment in their own residential neighborhood (OR = 0.3, 95{\%}CI 0.3-0.4) were less likely to receive HIV counseling and testing. CONCLUSION: Health care providers in Rio de Janeiro selectively offered HIV counseling and testing to persons they perceived to be at risk for HIV and those with advanced stages of TB. HIV counseling and testing should be expanded and offered to all TB patients.",
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