(Download) "High HIV-TB Co-Infection Rates in Marginalized Populations: Evidence from Alberta in Support of Screening TB Patients for HIV (COMMENTARY)" by Canadian Journal of Public Health # Book PDF Kindle ePub Free
eBook details
- Title: High HIV-TB Co-Infection Rates in Marginalized Populations: Evidence from Alberta in Support of Screening TB Patients for HIV (COMMENTARY)
- Author : Canadian Journal of Public Health
- Release Date : January 01, 2010
- Genre: Law,Books,Professional & Technical,
- Pages : * pages
- Size : 286 KB
Description
As experience from HIV-endemic countries has taught us, HIV and TB go hand in hand. HIV infection is a powerful risk factor for the reactivation of latent tuberculosis infection (LTBI) and a major contributor to the global resurgence of TB. Heretofore we have not seen strong evidence of this synergy in Canada, although this may simply reflect a lack of concurrent surveillance for the two diseases. To date, the goal of universal HIV testing of TB patients in Canada remains elusive (27.2% of TB patients were reported as HIV tested in 2006) despite the existence of two national advisories, one in 1992 and another in 2002, recommending universal HIV testing of TB patients. (1-3) In response to these advisories, we recently undertook to demonstrate the feasibility of using an 'opt-out' approach to achieve universal HIV testing (80% tested) of TB patients in Alberta. The 'opt-out' approach we used was patterned after an established program of 'opt-out' HIV testing in prenatal women. (4) It is akin to the 'provider-initiated' HIV testing program now promoted by the World Health Organization. (5,6) In it, patients are briefly informed about HIV's connection to TB and the routine testing of TB patients in Alberta for HIV unless they choose not to be tested. 'Opt-out' testing was extremely well received; by 2003 and every year thereafter, over 80% of TB patients were routinely tested for HIV. We first reported our findings in the March/April 2009 issue of the Canadian Journal of Public Health. (7) In the present commentary, we add two more years of data (20072008) to our earlier report and demonstrate for the first time that HIV co-infection is significantly greater in certain age and population groups of TB patients. Our findings underscore the need for universal concurrent testing as well as greater interaction between TB and HIV programs. (8) In 2003-2006 and 2007-2008, respectively, the proportion of TB patients who were HIV tested in Alberta was 81.9% and 94.6%; 87.4% and 99.5% in the age group 15-64 years where all of the HIV co-infected patients were situated (Table 1). In the two time periods combined, the proportion was 86.4%; 91.8% in the age group 15-64 years. In 2003-2006 and 2007-2008, respectively, the proportion of HIV-tested patients who were HIV positive was 5.4% and 7.6%; 7.4% and 10.4% in the age group 15-64 years. In the two time periods combined, the proportion was 6.3%; 8.5% in the age group 15-64 years.