Tracking TB-HIV Coinfection in the United States

Leave a comment New Media October 10, 2012

By Kevin Fenton, M.D., Ph.D., FFPH, Director, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, CDC, @CDC_DrFenton

Dr. Kevin Fenton

A recent tuberculosis (TB) report from the Centers for Disease Control and Prevention (CDC) found that fewer people in the United States have TB disease than in years past. A total of 10,528 TB cases were reported in the United States in 2011, a decrease from 11,171 cases in 2010. Despite this decrease in reported TB cases in 2011, the disease still remains a serious threat, especially for people living with HIV, as HIV can make TB worse. Worldwide, TB is one of the leading causes of death among people living with HIV.
To monitor TB and HIV coinfection, CDC collects data on HIV infection among people with TB. The most recent data provides the clearest picture yet of the intersection of these epidemics. This is due to more complete HIV reporting in the United States. All 50 states and the District of Columbia currently have confidential name-based HIV infection reporting. However, states implemented reporting at different times. For example, California did not begin reporting HIV diagnoses to CDC until 2011.
In 2011, the percentage of people with TB who reported being tested for HIV was 82%—an increase from 67% in 2010. The percentage of TB patients who reported HIV positive test results has dropped dramatically from 15% in 1993 to 6% in 2008 and has remained steady at 6% for the past 4 years.
TB and HIV coinfection underscores the need to integrate HIV testing programs for all people starting TB treatment, and timely TB testing for people living with HIV. At NCHHSTP, we aim to strengthen collaborative work across disease areas and integrate services for people at risk for multiple diseases through our program collaboration and service integration efforts. Small changes, in the way prevention services are delivered at the client-level, can make a dramatic difference by reaching a larger population with more services. It can also improve efficiency, cost-effectiveness and health outcomes, especially for those coinfected with TB and HIV.
TB Treatment for those with HIV
People living with HIV who also have either latent TB infection or TB disease can be effectively treated. The first step is to ensure that people with HIV are tested for TB infection. If the patient is found to have TB infection, further tests are needed to rule out TB disease. The next step is to start treatment for latent TB infection or TB disease based on test results. Fortunately, there are a number of treatment options for people living with HIV.
For more information, go to our TB Website or contact your state’s TB Control Office. For updates on TB and HIV on Twitter, follow me at @CDC_DrFenton