The double whammy of TB and AIDS.

The double whammy of TB and AIDS

In July 1987, a 40-year-old truck driver walked into a state-run clinic in Myrtle Beach, S.C., with symptoms of tuberculosis. Clinic workers were surprised because both teh man and his wife had been treated for tuberculosis years before. Once again, the main improved with treatment. But when his wife showed signs of reactivated tuberculosis later that same year, public health officials began to suspect a link to HIV, the virus that causes AIDS. Indeed, both patients tested positive for HIV, although both denied high-risk behavior for AIDS. Further medial sleuthing revealed that the virus had followed path of heterosexual transmission, infecting a total of five people in the predominantly rural area.

That case study, reported by Saundr C. Carmichael and her colleagues at the Waccamaw Public Health District, underscores the importance of the federal recommendation that physicians routinely test for HIV when confronted with a case of tuberculosis.

In a related report, Alan B. Bloch and Dixie E. Snider of the Centers for Disease Control in Atlanta have added to the evidence suggesting the United States is experiencing a surge in tuberculosis cases (SN: 2/6/88, p.92). From 1985 to 1988, they estimate, U.S. physicians reported more than 22,000 "excess" tuberculosis cases -- above and beyond the number projected based on past trends. Bloch and Snider blame the upswing on HIV, which damages the immune system and allows opportunistic microorganisms, including Mycobacterium tuberculosis, to flourish. Bloch says people with both HIV and TB must take anti-TB drugs for a longer period than people who have TB only.