Distribution of Mycobacterium tuberculosis and human immunodeficiency virus infections among contacts of tuberculosis patients

Abstract

Contacts of tuberculosis (TB) cases in households orsharing space in hospitals, classrooms, offices, market stalls or other, were evaluated by tuberculin skin test (TST), sputum-smear microscopy or sputum culture method for Mycobacterium tuberculosis and by serology for HIV infections. Of the 633 contacts, 47.4% were TST-positive and 18.2% HIV-infected. Household contacts were 174 and 51.2% of them were TST-positive and 8.0% HIV-positive. Spouse (TB-case)-spouse contacts gave 83.3% TSTpositive rate followed by mother (TB-case)-child contact (65.5%); father (TB-case)-child contact (35.0%) and other relationships (51.2%). In a three-year cohort study, 46.2% contacts, initially TST-and HIVpositive, developed TB compared with 16.7% among those TST-positive but HIV-negative. For those TB and HIV positive, 52.4% developed AIDS and 42.9% died compared with 22.3% AIDS rate and 18.2% deaths among those testing TST-negative but HIV-positive. This confirms interaction between HIV and TB; and the liaison of the two resulted in higher mortality.