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Medical Forum / General / General / March 2005

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TB contagious?

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martin lynch - 19 Mar 2005 20:29 GMT
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.

Signature

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.
Signature

Keith F. Lynch - http://keithlynch.net/
Please see http://keithlynch.net/email.html before emailing me.

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

**********************************
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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