2263. HIV-TB Co-Infection in Arizona From 1993 to 2016

Abstract

BackgroundKey risk factors for tuberculosis (TB) in the United States include HIV-positive status, birth outside of the United States, incarceration and homelessness. Despite advances in antiretroviral therapy (ART) and declining HIV-TB comorbidity, TB remains an important opportunistic infection for all people living with HIV. Few studies exist which characterize HIV-TB co-infection in geographic populations within the United States In this study, we cross-reference the HIV and TB registries in Arizona from 1993 through 2016 and compare features of HIV-TB co-infected individuals with HIV-negative TB cases and the broader population living with HIV.MethodsCase records were identified by cross-referencing two separate databases maintained by the Arizona Department of Health Services, the Report of Verified Case of Tuberculosis (RVCT) and the Enhanced HIV/AIDS Reporting System (eHARS). Data were organized and analyzed in SAS and comparisons evaluated with Pearson chi-square test.ResultsA total of 361 unique cases of HIV-TB co-infection in Arizona were identified during the study period. Annual TB diagnoses in people living with HIV range from 25 (1995) to 7 (2008 and 2016). Significant differences in birth sex and age were observed in HIV-TB co-infections compared with HIV-negative TB cases. Homelessness was more common among people living with HIV (22.6% vs. 9.0%, χ2 = 70.22, P < 0.001). TB disease manifestations differed (χ2 = 159.7604, P < 0.001) and HIV-positive individuals more frequently had concurrent pulmonary and extrapulmonary TB disease. Outcomes of TB treatment were less favorable among individuals living with HIV (χ2 = 45.33, P < 0.001) as more HIV-positive patients failed to complete the full course of TB therapy or died before therapy completion. Finally, among all people living with HIV, our study revealed significant differences in race (χ2 = 243.53, P < 0.001), country of birth (χ2 = 441.88, P < 0.001), HIV transmission risk factors (χ2 = 125.19, P < 0.001), and correctional status (χ2 = 347.90, P < 0.001) for those who had a TB diagnosis.ConclusionOur study reveals important trends in HIV-TB comorbidity in Arizona and may inform public health strategies for addressing TB and its burden among people living with HIV.Disclosures All authors: No reported disclosures.