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Sharp Decline of Comorbidity of Tuberculosis and HIV

Declines are greatest in states where burden of comorbidity was heaviest, study finds

FRIDAY, Dec. 14 (HealthDay News) -- Comorbid cases of tuberculosis (TB) and HIV declined sharply in the United States between 1993 to 2004, researchers report in the Dec. 10/24 issue of the Archives of Internal Medicine.

Rachel Albalak, Ph.D., of the U.S. Centers for Disease Control and Prevention in Atlanta, and colleagues analyzed all incident TB cases reported to the CDC during the 11-year study period. Propensity stratification was used to account for the unequal probability of patients with TB being tested for HIV during all the years of the study period.

The number of TB/HIV cases nationally decreased from 3,681 in 1993 (15 percent of all TB cases that year) to 1,187 in 2004 (8 percent of all TB cases that year). In states with the higher burdens of TB/HIV cases, comorbidity declined from 19 percent of all TB cases in 1994 to 9.2 percent of all TB cases in 2004. The percentage decline in comorbidity was greatest in persons between the ages of 25 to 44, although comorbidity rates also remained highest in that age group. Cases of comorbidity among males declined 71 percent over the study period and 56 percent among females. Comorbidity cases and rates steadily decreased among individuals born in the United States but remained stable among those born outside the United States.

"A remaining concern is the possibility that the successes in controlling TB/HIV comorbidity and TB morbidity overall will lead to a renewed cycle of neglect," the authors conclude.

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