Tuberculosis and the Acquired Immunodeficiency Syndrome at a New York City Hospital: 1978-1985

Recent reports have described an increase in cases of tuberculosis in several urban centers. To investigate the possible relationship between tuberculosis and the acquired immunodeficiency syndrome (AIDS), we reviewed case records at a New York City hospital between 1978 and 1985. During this period, tuberculosis occurred in 15.1 percent of AIDS patients with a history of parenteral drug use and 4.4 percent of all other patients with AIDS. The yearly rate of tuberculosis more than doubled during the study period; this increase was entirely attributable to cases among patients with AIDS or AIDS-related complex and parenteral drug users, a group at high risk for the development of AIDS. Patients with AIDS and tuberculosis were younger and more frequently men than other patients with tuberculosis, and were more likely to have extrapulmonic disease. In the majority of patients, tuberculosis occurred prior to confirmation of CDC-defined AIDS. Forty-four percent of patients with AIDS-related complex at the time of diagnosis of tuberculosis subsequently developed AIDS. Mycobacterium tuberculosis appears to be yet another opportunistic agent to which patients with AIDS retroviral-induced immunodeficiency are susceptible.