Tuberculosis and HIV co-infection in healthcare workers in England and Wales, 1999-2005

Epidemiol Infect. 2012 Oct;140(10):1873-9. doi: 10.1017/S0950268811002445. Epub 2011 Nov 25.


This study used linked national tuberculosis (TB) and HIV surveillance data to investigate recent trends and factors associated with HIV co-infection (TB-HIV) in healthcare workers (HCWs) with TB in England and Wales. Methods applied were the χ2 trend test and logistic regression. Overall 14% (231/1627) of HCWs with TB were co-infected with HIV, increasing from 8% in 1999 to 14% in 2005 (P<0·001). Most (78%) HCWs were non-UK born and 74% of these developed TB ⩾2 years post-entry. Being born in Sub-Saharan Africa was an independent predictor for TB-HIV, especially for female HCWs (odds ratio 66·5, 95% confidence interval 16·3-271·1), who also had a lower median CD4 count than other co-infected women (106/mm3, interquartile range 40-200, P<0·01). Voluntary HIV testing of new HCWs should be encouraged as an opportunity for early diagnosis. Post-entry, a high index of clinical suspicion for TB in those most at risk remains important.

MeSH terms

  • Adult
  • Coinfection / epidemiology*
  • England / epidemiology
  • Female
  • HIV Infections / complications*
  • HIV Infections / epidemiology*
  • Health Personnel*
  • Humans
  • Incidence
  • Male
  • Middle Aged
  • Prevalence
  • Tuberculosis / complications*
  • Tuberculosis / epidemiology*
  • Wales / epidemiology