Volume 19, Number 3—March 2013
CME ACTIVITY - Research
Tuberculosis and HIV Co-infection, California, USA, 1993–2008
, Travis C. Porco, Janice Westenhouse, Mark Damesyn, Matt Facer, Julia Hill, Qiang Xia, James P. Watt, Philip C. Hopewell, and Jennifer Flood
Table 1
Demographic characteristics of TB patients with and without known HIV co-infection, California, 1993–2008*
| Characteristic | TB without known HIV |
TB with HIV |
|||||
|---|---|---|---|---|---|---|---|
| 1993–1995, n = 13,297 | 1996–2000, n = 17,768 | 2001–2008, n = 22,558 | 1993–1995, n = 1,343 | 1996–2000, n = 1,307 | 2001–2008, n = 1,254 | p value† | |
| Median age, y (IQR) |
42 (27–62) |
45 (29–64)‡ |
47 (30–64)‡ |
37 (31–44) |
38 (33–45)‡ |
40 (34–48)‡ |
0.8 |
| Female sex | 5,343 (40) | 7,249 (41) | 9,294 (41) | 147 (11) | 177 (14) | 217 (17) | <0.001 |
| Referent |
1.0 (0.99–1.04) |
1.03 (1.00–1.05) |
Referent |
1.2 (1.0–1.5) |
1.6 (1.3–1.9) |
||
| Race/Ethnicity | |||||||
| Asian/Pacific Islander | 4,972 (37) | 7,429 (42) | 10,091 (45) | 52 (4) | 59 (5) | 105 (8) | 0.002 |
| Referent | 1.12 (1.09–1.15) | 1.19 (1.16–1.22) | Referent | 1.2 (0.8–1.7) | 2.2 (1.6–3.0) | ||
| Hispanic | 4,955 (38) | 6,306 (35) | 8,519 (38) | 512 (38) | 619 (47) | 714 (57) | <0.001 |
| Referent | 1.0 (0.9–1.0) | 1.01 (0.98–1.04) | Referent | 1.2 (1.1–1.4) | 1.5 (1.4–1.6) | ||
| Black, non-Hispanic | 1,483 (11) | 1,674 (10) | 1,628 (7) | 440 (33) | 369 (28) | 265 (21) | 0.18 |
| Referent | 0.9 (0.8–0.9) | 0.7 (0.6–0.7) | Referent | 0.9 (0.8–1.0) | 0.6 (0.6–0.7) | ||
| White, non-Hispanic | 1,776 (13) | 2,197 (12) | 2,174 (10) | 327 (24) | 252 (19) | 161 (13) | <0.001 |
| Referent |
0.9 (0.9–1.0) |
0.7 (0.7–0.8) |
Referent |
0.8 (0.7–0.9) |
0.5 (0.4–0.6) |
||
| Foreign born | 8,951 (67) | 12,635 (71) | 17,296 (77) | 488 (36) | 597 (46) | 784 (63) | <0.001 |
| Referent |
1.1 (1.0–1.1) |
1.1 (1.1–1.2) |
Referent |
1.3 (1.2–1.4) |
1.7 (1.6–1.9) |
||
| Country/region of origin | |||||||
| Mexico | 2,909 (32) | 3,826 (30) | 5,274 (30) | 295 (60) | 385 (64) | 502 (64) | 0.07 |
| Referent | 0.9 (0.9–1.0) | 0.9 (0.9–1.0) | Referent | 1.1 (1.0–1.2) | 1.1 (1.0–1.2) | ||
| Central America | 521 (6) | 611 (5) | 937 (5) | 77 (16) | 84 (14) | 93 (12) | 0.05 |
| Referent | 0.8 (0.7–0.9) | 0.9 (0.8–1.0) | Referent | 0.9 (0.7–1.2) | 0.8 (0.6–1.0) | ||
| Philippines | 1,745 (19) | 2,669 (21) | 3,580 (21) | 27 (6) | 28 (5) | 43 (5) | 0.44 |
| Referent | 1.1 (1.0–1.1) | 1.1 (1.0–1.1) | Referent | 0.8 (0.5–1.4) | 1.0 (0.6–1.6) | ||
| People’s Republic of China | 504 (6) | 774 (6) | 1,108 (6) | 3 (0.6) | 2 (0.3) | 2 (0.3) | 0.26 |
| Referent | 1.1 (1.0–1.2) | 1.1 (1.0–1.3) | Referent | 0.5 (0.1–3.3) | 0.4 (0.1–2.5) | ||
| Mainland Southeast Asia | 1,770 (20) | 2,391 (19) | 2,910 (17) | 10 (2) | 21 (4) | 39 (5) | <0.001 |
| Referent | 1.0 (0.9–1.0) | 0.9 (0.8–0.9) | Referent | 1.7 (0.8–3.6) | 2.4 (1.2–4.8) | ||
| Sub-Saharan Africa | 92 (1) | 181 (1) | 331 (2) | 7 (1) | 25 (4) | 52 (7) | 0.06 |
| Referent |
1.4 (1.1–1.8) |
1.9 (1.5–2.3) |
Referent |
2.9 (1.3–6.7) |
4.6 (2.1–10.1) |
||
| Median time from US entry to TB diagnosis, y (IQR) |
5.3 (1–13.6) |
8.2 (2.2–17.1)‡ |
10 (2.2–20.8)‡ |
9.8 (5–15.4) |
10.5 (4.5–18.5) |
10.9 (3–20.7) |
0.001 |
| HIV risk group§ | |||||||
| MSM | NA | NA | NA | 634 (47) | 578 (44) | 518 (41) | NA |
| NA | NA | NA | Referent | 0.9 (0.9–1.0) | 0.9 (0.8–1.0) | ||
| IDU | NA | NA | NA | 289 (22) | 276 (21) | 186 (15) | NA |
| NA | NA | NA | Referent | 1.0 (0.8–1.1) | 0.7 (0.6–0.8) | ||
| MSM and IDU | NA | NA | NA | 218 (16) | 137 (10) | 105 (8) | NA |
| NA | NA | NA | Referent | 0.7 (0.5–0.8) | 0.5 (0.4–0.6) | ||
| Heterosexual contact | NA | NA | NA | 84 (6) | 112 (9) | 206 (16) | NA |
| NA | NA | NA | Referent | 1.4 (1.0–1.8) | 2.6 (2.1–3.3) | ||
| Unknown | NA | NA | NA | 92 (7) | 188 (14) | 223 (18) | NA |
| NA | NA | NA | Referent | 2.1 (1.7–2.7) | 2.6 (2.1–3.3) | ||
| Homeless | 930 (7) | 1,059 (6) | 1,270 (6) | 244 (18) | 233 (18) | 239 (19) | 0.01 |
| Referent | 0.9 (0.8–0.9) | 0.8 (0.7–0.9) | Referent | 1.0 (0.8–1.2) | 1.1 (0.9–1.2) | ||
| Excess alcohol use | 1,270 (10) | 1,897 (11) | 2,071 (9) | 255 (19) | 298 (23) | 255 (20) | 0.8 |
| Referent | 1.1 (1.0–1.2) | 1.0 (0.9–1.0) | Referent | 1.2 (1.0–1.4) | 1.1 (0.9–1.3) | ||
*TB diagnoses were grouped into 3 periods: pre-HAART (1993–1995), early HAART (1996–2000), and late HAART (2001–2008). All values are no. (%)/prevalence ratio (95% CI) unless otherwise indicated. The denominator for each characteristic excludes missing or unknown values. TB, tuberculosis; IQR, interquartile range; MSM, men who have sex with men; NA, not applicable; IDU, injection drug use.
†Rates of change in prevalence of binary covariates among patients with TB vs. patients with TB–HIV were compared by using logistic regression with robust SEs; similarly, rates of change in continuous covariates among patients with TB vs. patients with TB–HIV were compared by using linear regression. For difference in annual percentage change (TB vs. TB–HIV)
‡p<0.001 difference in medians relative to early time period.
§Other exposure categories are hemophilia/coagulation disorder; receipt of blood, components, or tissue; and perinatal transmission. These accounted for <2% of suspected risk factors for HIV acquisition during each time period and are not included in the table.