       Document 0362
 DOCN  M9460362
 TI    Tuberculosis among patients with AIDS and a control group in an
       inner-city community.
 DT    9404
 AU    Given MJ; Khan MA; Reichman LB; Pulmonary Division, Seton Hall
       University School of Graduate; Medical Education, South Orange, NJ.
 SO    Arch Intern Med. 1994 Mar 28;154(6):640-5. Unique Identifier : AIDSLINE
       MED/94175648
 AB    BACKGROUND: Tuberculosis, the largest single cause of death of any
       infectious disease worldwide, has undergone a startling resurgence in
       the United States, partially related to the acquired immunodeficiency
       syndrome (AIDS) epidemic. METHODS: To compare the clinical,
       roentgenographic, and bacteriologic characteristics of patients with
       AIDS and the general population, we retrospectively analyzed the
       clinical records of all patients with tuberculosis in an inner-city
       population over a 4-year period. Forty-six patients with AIDS (including
       38 injecting drug users [83%]) were identified and matched with a
       control group of 46 patients with tuberculosis who did not have AIDS.
       RESULTS: Forty-one patients with AIDS (89%) had pulmonary tuberculosis;
       10 (22%) had disseminated disease and 13 (28%) had concurrent
       extrapulmonary disease. Among the patients without AIDS, two (4%) had
       disseminated disease and four (9%) had extrapulmonary disease. Patients
       with AIDS were far more likely to be black. Thirty-seven patients with
       AIDS (80%) had negative purified protein derivative skin test results
       compared with eight controls (17%). Seventeen (41%) of 41 patients with
       AIDS presented with classic post-primary upper-lobe disease compared
       with 32 (73%) of 44 patients in the control group. Primary tuberculosis
       features occurred predominantly in the AIDS group. Four (10%) of 41
       patients with AIDS presented with clear chest films despite positive
       smears and cultures. Nine patients with AIDS (20%) were drug-resistant
       compared with three controls (7%). Seven patients with AIDS with drug
       resistance were born in the United States (78%), while all controls with
       drug resistance were foreign-born. CONCLUSIONS: We found vast
       differences in the clinical, roentgenographic, and drug susceptibility
       characteristics of patients with tuberculosis who did and did not have
       AIDS.
 DE    Adult  AIDS-Related Opportunistic Infections/DIAGNOSIS/DRUG THERAPY/
       *MICROBIOLOGY  Female  Human  Male  Middle Age  New Jersey/EPIDEMIOLOGY
       Retrospective Studies  Support, Non-U.S. Gov't  Support, U.S. Gov't,
       P.H.S.  Tuberculosis/DIAGNOSIS/DRUG THERAPY/*MICROBIOLOGY  Tuberculosis,
       Multidrug-Resistant/EPIDEMIOLOGY  Tuberculosis, Pulmonary/MICROBIOLOGY
       Urban Health  JOURNAL ARTICLE

       SOURCE: National Library of Medicine.  NOTICE: This material may be
       protected by Copyright Law (Title 17, U.S.Code).

