Abstract

Background: Tuberculosis (TB) in Chile is reaching the elimination phase, however, in HIV positive individual the incidence of TB in still very high. Aim: To describe the association between TB and HIV in different geographical regions in Chile, and to determine the association between 773 and HIV/AIDS) mortality. Patients and methods: A retrospective study that included individuals from the main HIV clinics from four regions with different TB prevalence in the general population (per 100,000): Arica (> 30), Concepcion/Arauco (25-29), Valparaiso/San Antonio (20-24) and Metropolitana Sur-Oriente (SSMSO) ( 20), attended between january 1998 and september 2004. Results. Nine hundred and twelve HIV positive individuals were included. Gobal prevalence of TB was 6.2% [95916 confidence intervals (Q) 5-2-72%. TB was more common in older subjects (p =0.039) and those with lower CD4 counts (p 0.001) and higher HIV viral load (p =0.033). In 66% of cased, the disease bad a pulmonary localization. TB was the recorded cause (of death in 7.4% of subjects. Only 2996 of patients bad a tuberculin skin test performed at the moment of HIV diagnosis. The prevalence of 773 in HIV positive patients, followed the trend of TB prevalence in the general population: Concepcion/Arauco (11-9%), Valparaiso/San Antonio (71%) and SSMSO (3.9%). However HIV positive subjects from Arica showed an unexpectedly low 773 prevalence (5.5%). Conclusions: TB in HIV/AIDS patients included in this study is over 300 times more prevalent than in the general population. TB prevalence in HIV positive subjects follows regional TB prevalence, excepting Arica. Effectiveness and feasibility of latent TB diagnostic strategies and treatment in HIV positive individuals should be reviewed (Rev Med Chile 2008; 136: 578-86).