Prevalence of Human Immunodeficiency Virus Infection among Patients Attending Tuberculosis Clinics in the United States

In 1988-1989, surveillance for human immunodeficiency virus (HIV) infection was conducted in 20 clinics providing medical care for patients with suspected and confirmed tuberculosis (TB) in 14 cities. A total of 3077 specimens from consecutive patients were tested for HIV after patient identifiers were removed. The median clinic seroprevalence rate was 3.4%, (range, 0-46.3%). The highest rates were found in the Northeast and Atlantic coastal areas. Rates by clinic were highest for persons born in the United States (median, 11.2%) and in the Caribbean region (Haitians, 36%-40%, and Cubans, 16%). Most HIV-infected patients had pulmonary TB, but HIV infections were more frequent in patients with extrapulmonary TB than in pulmonary TB patients (19.8% vs. 10.2%, P less than .0002). For US-born patients, rates did not differ by race or sex. These serosurveillance data indicate widespread HIV infection among TB patients and have important implications for clinical management of TB patients and for TB and AIDS prevention programs. Testing all HIV-infected persons and all TB patients for dual infection is essential to control the interrelated epidemics of AIDS and TB.