Evolution of tuberculosis/HIV co-infection in California during the HAART Era, 1996-2007

Abstract

Background California reports the highest annual number of tuberculosis (TB) cases and over 12% of all persons living with HIV in the US. To assess changes in the intersection of these diseases, we analyzed state-wide data from both registries. Methods Incident cases reported to the California TB registry from 1996 to 2007, inclusive, were cross-matched with the state HIV/AIDS registry. Incidence rates of TB with and without HIV co-infection were analyzed for changes in trend. Sociodemographic, clinical characteristics, and treatment outcomes were examined. Results 2,392 (6%) of 39,718 TB cases during the study period were matched in the state AIDS registry. From 1996 to 2006, annual TB incidence among persons with HIV declined from 368/100,000 to 73/100,000, and without HIV declined from 12.7/100,000 to 7.3/100,000. Comparing the period 1996-2000 with 2001-2007, the proportion of TB/HIV cases increased among Hispanics (48% to 57%; p < .001), foreign born (46% to 63%; p < .001). Maleto- male sexual contact (44% to 41%; p < .01) and injection drug use (21% to 15%; p < .01) decreased, and high-risk heterosexual contact (9% to 16%; p