HIV infection and tuberculosis: an epidemiological study from a French register.

SETTING

The possible impact of the human immunodeficiency virus (HIV) infection on the epidemiology of tuberculosis has never been studied in a general French population.

OBJECTIVE

To describe the evolution of tuberculosis incidence from 1983 to 1991 in a French district (Rhône) and to assess its relationships to HIV-related factors, and to determine the prevalence of HIV infection among adult tuberculosis patients registered from 1989 to 1991.

DESIGN

Information on sex, age, country of birth and the history and site of tuberculosis was derived from notification forms, and information on HIV testing was collected especially for this study.

RESULTS

During these nine years, 2916 tuberculosis cases were registered. The incidence increased in 1991 after a slow decline in previous years. An analysis of the evolution in the distribution of cases did not suggest any effect of HIV infection on the epidemiology of tuberculosis, with the exception of an increase in the proportion of patients originating from the Antilles and sub-Saharan Africa. The conservative estimate of prevalence of HIV infection was 9.8% in young adult patients.

CONCLUSION

The overlap between the population with HIV infection and that with tuberculosis seems to be small and restricted to particularly vulnerable sub-groups of the population of this region.