       Document 0241
 DOCN  M95A0241
 TI    Sociodemographic predictors and temporal trends of extrapulmonary
       tuberculosis as an AIDS-defining disease in Spain.
 DT    9510
 AU    Castilla J; Gutierrez-Rodriguez A; Tello O; National Centre for
       Epidemiology, Carlos III Institute of Health,; Madrid, Spain.
 SO    AIDS. 1995 Apr;9(4):383-8. Unique Identifier : AIDSLINE MED/95314794
 AB    OBJECTIVE: To identify the factors associated with the presentation of
       extrapulmonary tuberculosis (EPTB) in AIDS diagnosis and to analyse its
       temporal trend. DESIGN: Analysis of AIDS surveillance data. METHODS: The
       study was based on AIDS cases diagnosed in Spain between 1988 and 1993,
       and reported up to September 1994. The proportion of patients presenting
       with EPTB at AIDS diagnosis was analysed by sociodemographic
       characteristics and year of diagnosis. RESULTS: Of the 22,445 AIDS cases
       diagnosed in Spain from 1988 to 1993, 6526 patients (29.1%; 95%
       confidence interval, 28.5-29.7) presented with EPTB at diagnosis, making
       it the most frequent AIDS-defining disease. The highest proportions of
       EPTB reported at AIDS diagnosis were observed for injecting drug users
       (IDU; 35.4%) and the heterosexual transmission category (23.5%). The
       proportion of EPTB was lower in women [relative risk (RR), 0.85; P <
       0.001], and higher in 15-29-year-olds (34.2%) and patients with a prison
       record (44.3 versus 25.4%; RR, 1.75; P < 0.001). AIDS patients resident
       in provinces with high respiratory TB mortality rates among the general
       population exhibited a higher proportion of EPTB (RR, 1.45; P < 0.001).
       The effect of any one variable was maintained by controlling for all
       others. The proportion of patients with EPTB at AIDS diagnosis revealed
       a downward trend from 1988 to 1993 (P = 0.007), which was observed in
       IDU and heterosexuals but not in homosexual/bisexual men (P = 0.421).
       CONCLUSIONS: Factors such as injecting drug use, prison record or
       residence in high TB-endemic areas are associated with a greater
       frequency of EPTB at AIDS diagnosis. These factors must be considered
       for specific prophylaxis to be efficiently applied.
 DE    Acquired Immunodeficiency Syndrome/DIAGNOSIS  Adolescence  Adult
       AIDS-Related Opportunistic Infections/*EPIDEMIOLOGY/PREVENTION &
       CONTROL  Bisexuality  Epidemiologic Factors  Female  Homosexuality, Male
       Human  Male  Prisoners  Risk Factors  Sex Behavior  Spain/EPIDEMIOLOGY
       Substance Abuse, Intravenous/COMPLICATIONS  Support, Non-U.S. Gov't
       Tuberculosis/*COMPLICATIONS/*EPIDEMIOLOGY/PREVENTION & CONTROL  JOURNAL
       ARTICLE

       SOURCE: National Library of Medicine.  NOTICE: This material may be
       protected by Copyright Law (Title 17, U.S.Code).

