Ahmed AB, Abubakar I, Delpech V , Lipman M, Boccia D , Forde J , Antoine D, Watson JM "The growing impact of HIV infection on the epidemiology of tuberculosis in England and Wales: 1999-2003 " THORAX 62 (8): 672-676 AUG 2007

[Eugene Garfield]

E-mail Addresses: john.watson at hpa.org.uk 

Title: The growing impact of HIV infection on the epidemiology of 
tuberculosis in England and Wales: 1999-2003 
 
Author(s): Ahmed AB (Ahmed, Aliko B.), Abubakar I (Abubakar, Ibrahim), 
Delpech V (Delpech, Valerie), Lipman M (Lipman, Marc), Boccia D (Boccia, 
Delia), Forde J (Forde, Josh), Antoine D (Antoine, Delphine), Watson JM 
(Watson, John M.) 

Source: THORAX 62 (8): 672-676 AUG 2007 

Document Type: Article 

Language: English 

Cited References: 21      Times Cited: 0        

Abstract: 
Background: Previous studies have estimated the prevalence of tuberculosis 
and HIV infection in population subgroups in the UK. This study was 
undertaken to describe recent trends in the proportion of individuals with 
HIV infection among reported cases of tuberculosis in England and Wales, 
and to review the implications for clinical and public health care. 

Methods: 
A population-based matching study using national surveillance databases was 
used to investigate all persons aged 15 years and over reported with a 
diagnosis of tuberculosis to the Health Protection Agency in England and 
Wales in 1999-2003. Record linkage was used to match the national 
tuberculosis and HIV/ AIDS surveillance databases to identify all cases of 
tuberculosis and determine the proportion of patients with tuberculosis co-
infected with HIV. The distribution and characteristics of the cases were 
determined and the trend examined by year.

Results: 
Of 30 670 cases of tuberculosis reported in England and Wales between 1999 
and 2003, an estimated 1743 (5.7%) were co-infected with HIV. There was a 
year on year increase in the proportion from 3.1% (169/5388) in 1999 to 
8.3% (548/6584) in 2003 (p for trend <0.0001). Co-infected patients 
contributed to almost a third of the increase in the number of cases of 
tuberculosis during the 5 year period. Patients co-infected with HIV were 
predominantly those born abroad. 18.5% (n = 323) of co-infected patients 
had not been reported as active cases of tuberculosis on the national 
tuberculosis database.

Conclusion: 
The proportion of patients with tuberculosis co-infected with HIV in 
England and Wales is increasing, with the greatest impact on those born 
abroad regardless of their ethnic origin. With HIV infection contributing 
substantially to the increase in the number of cases of tuberculosis, close 
cooperation in the clinical management and accurate notification of 
patients is vital if appropriate care and public health action is to be 
achieved.

Addresses: Watson JM (reprint author), Hlth Protect Agcy, Dept Resp Dis, 
Ctr Infect, London NW9 5EQ, England
Hlth Protect Agcy, Dept Resp Dis, Ctr Infect, London NW9 5EQ, England
Univ E Anglia, Sch Med Hlth Policy & Practice, Norwich NR4 7TJ, Norfolk 
England
Royal Free Hosp, London NW3 2QG, England

E-mail Addresses: john.watson at hpa.org.uk 

Publisher: B M J PUBLISHING GROUP, BRITISH MED ASSOC HOUSE, TAVISTOCK 
SQUARE, LONDON WC1H 9JR, ENGLAND 
Subject Category: Respiratory System 
IDS Number: 199IQ 

ISSN: 0040-6376 


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