Tuberculosis and human immunodeficiency virus infection in the Central African Republic

In order to determine the proportion of tuberculosis (TB) patients in Bangui (Central Africa Republic) infected with human immunodeficiency virus (HIV) serum samples were prospectively collected from all new TB patients seen at the University Hospital in Bangui from November 1987- January 1988. 220 serum samples were tested for antibodies to HIV by an ELISA assay and confirmed by Western blot. The general HIV seropositivity rate among TB patients was 27.7% (31.2% in adults; n=183) and 10.8% in children (n=37). Within the adult population there was nonassociation between HIV infection and sex or previous history of TB. Seropositivity was more common in patients with extrapulmonary TB especially lymphadenitis and in patients with mediastinal adenopathy or extensive pulmonary involvement without cavitation. Seropositivity was also strongly associated with negative tuberculin skin tests chronic diarrhea generalized lymphadenopathy and thrust. It is concluded that HIV infection is responsible for the increasing incidence of tuberculosis in Central African Republic and that investigations for TB should be carried out in every symptomatic African patient infected with HIV. (authors)