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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
Impact of human immunodeficiency virus and CD4 count on tuberculosis diagnosis: Analysis of city-wide data from Cape Town, South Africa
International Journal of Tuberculosis and Lung Disease, Volume 17, No. 8, Year 2013
Notification
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Description
BACKGROUND: The impact of human immunodeficiency virus (HIV) infection and CD4 count on the diagnosis of tuberculosis (TB) at population level is incompletely defined. OBJECTIVE: To determine how HIV infection and CD4 count affect disease site, sputum smear status and overall rate of laboratory confirmation (sputum smear microscopy or culture) of TB cases under routine programme conditions. DESIGN: Retrospective analysis of the 2009 electronic TB register for Cape Town, South Africa. RESULTS: Of 29 478 TB cases notified in 2009, HIV status was known for 25 744 (87.3%) cases, of whom 13 237 (51.4%) were HIV-positive. Of these, 61.2% had CD4 cell counts of <200 cells/μl and 82.7% had counts of <350 cells/μl. Laboratory confirmation of TB (by smear or culture) was obtained less frequently in HIV-infected than non-HIV-infected adult cases (53.9% vs. 74.3%, P < 0.001). HIV infection was associated with a higher proportion of sputum smear-negative and extrapulmonary TB and lower grades of sputum smear positivity even among those with CD4 counts of ≥500 cells/ μl. However, the relationship between the proportion of smear-positive cases and CD4 count was non-linear. CONCLUSION: Much TB is not laboratory-confirmed in this setting despite good laboratory services. HIV-associated TB is more difficult to diagnose even at high CD4 cell counts of >500 cells/μl, suggesting early impact after HIV seroconversion. © 2013 The Union.
Authors & Co-Authors
Gupta, Rishi K.
Unknown Affiliation
Lawn, Stephen D.
Unknown Affiliation
Bekker, Linda-Gail Gail
Unknown Affiliation
Caldwell, Judy
Unknown Affiliation
Kaplan, Richard
Unknown Affiliation
Wood, Robin Y.
Unknown Affiliation
Statistics
Citations: 44
Authors: 6
Affiliations: 4
Identifiers
Doi:
10.5588/ijtld.13.0032
ISSN:
10273719
Research Areas
Infectious Diseases
Study Design
Cross Sectional Study
Cohort Study
Study Locations
South Africa