Med student here...
In pathology, our prof was lecturing on infectious diseases, and
nonchalantly mentions that up to 1/3 of HIV patients may have TB
(estimate).
Next year I will be in clininc, seeing HIV patients on a daily basis.
Why such a nonchalant mention of TB? Shouldn't there be GREAT concern
that health workers that treat HIV patients will contract TB? Or is
it unlikely to spread to a non-immunocompromised individual?
David Rind - 19 Mar 2005 23:56 GMT
> Med student here...
>
[quoted text clipped - 6 lines]
> that health workers that treat HIV patients will contract TB? Or is
> it unlikely to spread to a non-immunocompromised individual?
Active tuberculosis is fairly infectious, but, assuming we are talking
about the US, the rates of TB in HIV are nowhere near that high.
I suspect the professor misspoke or you misheard. The figure seems just
about backwards -- that is, the 1/3 number seems about right for the
fraction of people in some cities in the US presenting with active TB
who turn out to be infected with HIV.

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David Rind
drind@caregroup.harvard.edu
Keith F. Lynch - 29 Mar 2005 04:33 GMT
martin lynch wrote:
> In pathology, our prof was lecturing on infectious diseases, and
> nonchalantly mentions that up to 1/3 of HIV patients may have TB
> (estimate).
I've heard that about 1/3 of the people in the world are infected with
TB, not just the ones who have HIV. Fortunately, most of them never
have any symptoms.

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Keith F. Lynch - http://keithlynch.net/
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Jeff - 20 Mar 2005 00:33 GMT
> Med student here...
>
[quoted text clipped - 6 lines]
> that health workers that treat HIV patients will contract TB? Or is
> it unlikely to spread to a non-immunocompromised individual?
You really need to talk to your student health services about this.
It sounds like you should be tested for TB now and a regular intervals there
after, like every year or something.
I would be surprised if they don't have something worked out already.
I remember when I was in med school, when the HIV things was just getting
started, in the late 80s. One of my patients was a gentleman who later
turned out to have MAI. I got a call from student health services, because
the inital test could tell the difference between that and TB.
Jeff
Robert A. Fink, M. D. - 20 Mar 2005 06:16 GMT
>Med student here...
>
[quoted text clipped - 6 lines]
>that health workers that treat HIV patients will contract TB? Or is
>it unlikely to spread to a non-immunocompromised individual?
TB has always been something to which medical students have been
exposed. When I went to medical school it was required to have TB
testing every year and anyone who was tuberculin-negative and
"converted" was treated with drugs. People who started out with
positive tuberculin tests got chest x-rays yearly.
Most people in the USA who are non immunocompromised are either
resistant to infection or have been infected (the so-called "Ghon
complex") and are "immune".
There is, however, a growing incidence of drug-resistant TB out there,
usually as a result of incomplete treatment of infected individuals.
Best,
Bob
Robert A. Fink, M. D.
Neurological Surgery
2500 Milvia Street Suite 222
Berkeley, CA 94704-2636 USA
510-849-2555
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NOTE: The material above is not "medical
advice". Medical advice can only be
given after an in-person contact between
doctor and patient.
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