Understanding the Profile of Tuberculosis and Human Immunodeficiency Virus Coinfection: Insights from Expanded HIV Surveillance at a Tuberculosis Facility in Durban, South Africa.

Abstract

Background. Expanded HIV surveillance in TB patients forms part of the World Health Organization framework for strategic collaborative activity. Surveillance helps understand the epidemiology of the local dual epidemic and enables design of a tailored response to these challenges. Methods. We conducted an observational, cross-sectional study of anonymous unlinked HIV testing for 741 consecutive TB suspects attending an urban TB facility during a seven-week period in 2008. Results. A total of 512 patients were found to have TB. The mean age was 35.7 years, and 63% were male. The prevalence of HIV was 72.2% (95% CI: 68.2-75.9) in all TB cases, 69.8% (95% CI: 65.3-74.2) in pulmonary tuberculosis (PTB), 81.6% (95% CI: 72.9-90.3) in extrapulmonary disease, and 66.8% (95% CI: 60.7-72.9) in those without TB disease. HIV prevalence in TB patients was higher in females than males and in younger age groups (18-29 years). The sex ratio of PTB patients correlated with the sex ratio of the prevalence of HIV in the respective age groups (P < 0.05). Conclusion. The use of a rapid HIV test performed on sputum anonymously provides an opportunity for HIV surveillance in this high-burdened setting, which has the potential to lend valuable insight into the coepidemics.