Impact of human immunodeficiency virus and CD4 count on tuberculosis diagnosis: analysis of city-wide data from Cape Town, South Africa
The international journal of tuberculosis and lung disease, 2013•ingentaconnect.com
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 …
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 …
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 PCONCLUSION: 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.
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