High incidence of sputum smear negative tuberculosis during HAART in Burkina Faso

To the Editors: Tuberculosis (TB) and HIV co-infection is a public health priority in sub-Saharan Africa, where TB is the leading cause of death among HIV infected patients and the first manifestation of the HIV infection. 1–3. An unprecedented global effort allowed increasing access to antiretroviral treatment in Africa, where >2 million persons received highly active antiretroviral therapy (HAART) at the end of 2007 1. There is evidence that HAART reduces the risk of TB, in both industrialised 4 and resource-limited countries in sub-Saharan Africa and south-east Asia 5–9. However, there is no information on the HAART impact on the incidence of the different TB forms (sputum smear positive pulmonary (SSP-PTB), sputum smear negative (SSN-PTB) and extrapulmonary (EPTB)). We have measured TB incidence in a retrospective cohort of HIV infected persons who started HAART in four HIV/AIDS treatment centres in Ouagadougou, Burkina Faso. All consecutive HIV-seropositive patients aged …