Important note: Information in this article was accurate in 2007. The state of the art may have changed since the publication date.
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Reuters NewMedia - October 26, 2007
Will Dunham
The U.S. Centers for Disease Control and Prevention released a report that details the link between TB and HIV in the United States. Worldwide, TB is the leading cause of death among people infected with HIV.
Nine percent of all people with active TB in the United States tested positive for human immunodeficiency virus infection in 2005. But HIV infection status remained unknown in 31 percent of TB patients because they refused testing or were not offered a test, the CDC report said.
"HIV increases TB progression and TB increases HIV progression. And they result in a synergy that can be deadly," CDC epidemiologist Suzanne Marks, one of the authors of the report, said in a telephone interview.
Nearly two-thirds of those with HIV infection and TB are black, according to the report, which used data from every state except California.
The CDC calls for routine HIV testing of all TB patients. People with both TB and HIV are five times more likely to die during treatment for TB than patients who are not HIV infected, the agency said.
The unknown HIV status of U.S. TB patients in 2005 was far lower than in the early 1990s, the CDC said. In 1993, the HIV status of some 65 percent of U.S. TB patients was unknown.
"Increased promotion of routine HIV testing and rapid HIV tests might increase acceptability of testing, which would allow health-care providers to know the HIV status of a greater percentage of TB patients and enable them to provide optimal care," the CDC report said.
One in six black TB patients was HIV positive, compared to one in 20 HIV-infected white TB patients, the report said.
"High rates of both HIV infection and TB disease among non-Hispanic blacks emphasize the need in this population to prevent, diagnose early and provide access to care for both conditions," the CDC report said.
TB is caused by bacteria that typically attack the lungs. It is spread through the air when a person with active TB of the lungs or throat coughs or sneezes.
The CDC previously reported that 13,779 TB cases were reported in the United States in 2006, a 3 percent decline from 2005. Of the 2006 cases, 57 percent involved foreign-born people.
There were 646 U.S. deaths from TB in 2005, the CDC said.
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