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The number of reported cases of tuberculosis with HIV co-infection has almost doubled in five yearsin England and Wales, the latest surveillance data show. Most of the increase has occurred in London.
Patients aged between 16 and 54 at diagnosis on the 1993 and 1998 National Tuberculosis Survey databases were matched with those on the HIV/AIDS patient database for the same period, to find out to what extent HIV infection has contributed to the recent national rise in TB prevalence.
In 1993, 2833 patients in this age group were included in the TB survey. By 1998 this had risen 21% to 3432. Database matching showed that 61 (2.2%) of patients with TB were co-infected with HIV in England and Wales in 1993. Five years later, this had risen to 112 (3.3%). Injecting drug use comprised only a small proportion of the likely route of co-infection.
HIV infection accounted for an estimated 8.5% of the increase in the numbers of new TB cases nationwide, and 11% in London. In both survey years the prevalence of co-infection was highest in the capital (64% and 77%), and among people of white and black African ethnicities.
These figures are unlikely to represent the true extent of co-infection, say the authors, who suggest that routine HIV testing of all patients with TB should now be considered, particularly those who are white or black African and under the age of 55.
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