Timely HIV diagnosis and HIV/TB comanagement among California patients in 2008

Darryl Kong, James P. Watt, Suzanne M. Marks, Jennifer M. Flood

Research output: Contribution to journalArticle

Abstract

Objective. National guidelines highlight the roles of early HIV diagnosis and effective comanagement for HIV and tuberculosis (TB) to prevent mortality and morbidity from HIV-related TB. We assessed HIV diagnosis timing and HIV/TB comanagement for California HIV/TB patients. Methods. We reviewed and analyzed public health charts for California HIV/TB patients reported during 2008. HIV diagnoses fewer than three months before TB diagnosis were considered new HIV diagnoses. We determined the proportion of patients with new HIV diagnoses, risk factors for new HIV diagnoses, and proportion of patients receiving recommended CD4 cell count measurements, supervised TB therapy, and antiretroviral therapy (ART). Results. Of 130 HIV/TB patients, 51% had new HIV diagnoses. Foreign-born patients were more likely than U.S.-born patients to have new HIV diagnoses. Supervised TB therapy and CD4 cell count measurements followed national recommendations for 91% and 74% of patients, respectively. At least 73% of patients started ART before completing TB therapy. Compared with patients who had previous HIV diagnoses, patients with new HIV diagnoses started ART later and had lower CD4 cell counts and higher viral loads at TB diagnosis. Conclusions. Although most HIV/TB patients received the recommended treatment, half had new HIV diagnoses. Compared with patients who had previous HIV diagnoses, patients with new HIV diagnoses had greater immunosuppression at TB diagnosis. A new diagnosis indicates that HIV could have been diagnosed earlier and ART or treatment for latent TB infection could have been initiated to prevent TB development.

Original languageEnglish (US)
Pages (from-to)170-177
Number of pages8
JournalPublic Health Reports
Volume129
Issue number2
StatePublished - Mar 2014
Externally publishedYes

Fingerprint

Tuberculosis
HIV
CD4 Lymphocyte Count
Therapeutics
Latent Tuberculosis
Secondary Prevention
Viral Load
Immunosuppression
Early Diagnosis

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health

Cite this

Kong, D., Watt, J. P., Marks, S. M., & Flood, J. M. (2014). Timely HIV diagnosis and HIV/TB comanagement among California patients in 2008. Public Health Reports, 129(2), 170-177.

Timely HIV diagnosis and HIV/TB comanagement among California patients in 2008. / Kong, Darryl; Watt, James P.; Marks, Suzanne M.; Flood, Jennifer M.

In: Public Health Reports, Vol. 129, No. 2, 03.2014, p. 170-177.

Research output: Contribution to journalArticle

Kong, D, Watt, JP, Marks, SM & Flood, JM 2014, 'Timely HIV diagnosis and HIV/TB comanagement among California patients in 2008', Public Health Reports, vol. 129, no. 2, pp. 170-177.
Kong, Darryl ; Watt, James P. ; Marks, Suzanne M. ; Flood, Jennifer M. / Timely HIV diagnosis and HIV/TB comanagement among California patients in 2008. In: Public Health Reports. 2014 ; Vol. 129, No. 2. pp. 170-177.
@article{aa5c200387db4b8cba45eebf7bbb4427,
title = "Timely HIV diagnosis and HIV/TB comanagement among California patients in 2008",
abstract = "Objective. National guidelines highlight the roles of early HIV diagnosis and effective comanagement for HIV and tuberculosis (TB) to prevent mortality and morbidity from HIV-related TB. We assessed HIV diagnosis timing and HIV/TB comanagement for California HIV/TB patients. Methods. We reviewed and analyzed public health charts for California HIV/TB patients reported during 2008. HIV diagnoses fewer than three months before TB diagnosis were considered new HIV diagnoses. We determined the proportion of patients with new HIV diagnoses, risk factors for new HIV diagnoses, and proportion of patients receiving recommended CD4 cell count measurements, supervised TB therapy, and antiretroviral therapy (ART). Results. Of 130 HIV/TB patients, 51{\%} had new HIV diagnoses. Foreign-born patients were more likely than U.S.-born patients to have new HIV diagnoses. Supervised TB therapy and CD4 cell count measurements followed national recommendations for 91{\%} and 74{\%} of patients, respectively. At least 73{\%} of patients started ART before completing TB therapy. Compared with patients who had previous HIV diagnoses, patients with new HIV diagnoses started ART later and had lower CD4 cell counts and higher viral loads at TB diagnosis. Conclusions. Although most HIV/TB patients received the recommended treatment, half had new HIV diagnoses. Compared with patients who had previous HIV diagnoses, patients with new HIV diagnoses had greater immunosuppression at TB diagnosis. A new diagnosis indicates that HIV could have been diagnosed earlier and ART or treatment for latent TB infection could have been initiated to prevent TB development.",
author = "Darryl Kong and Watt, {James P.} and Marks, {Suzanne M.} and Flood, {Jennifer M.}",
year = "2014",
month = "3",
language = "English (US)",
volume = "129",
pages = "170--177",
journal = "Public Health Reports",
issn = "0033-3549",
publisher = "Association of Schools of Public Health",
number = "2",

}

TY - JOUR

T1 - Timely HIV diagnosis and HIV/TB comanagement among California patients in 2008

AU - Kong, Darryl

AU - Watt, James P.

AU - Marks, Suzanne M.

AU - Flood, Jennifer M.

PY - 2014/3

Y1 - 2014/3

N2 - Objective. National guidelines highlight the roles of early HIV diagnosis and effective comanagement for HIV and tuberculosis (TB) to prevent mortality and morbidity from HIV-related TB. We assessed HIV diagnosis timing and HIV/TB comanagement for California HIV/TB patients. Methods. We reviewed and analyzed public health charts for California HIV/TB patients reported during 2008. HIV diagnoses fewer than three months before TB diagnosis were considered new HIV diagnoses. We determined the proportion of patients with new HIV diagnoses, risk factors for new HIV diagnoses, and proportion of patients receiving recommended CD4 cell count measurements, supervised TB therapy, and antiretroviral therapy (ART). Results. Of 130 HIV/TB patients, 51% had new HIV diagnoses. Foreign-born patients were more likely than U.S.-born patients to have new HIV diagnoses. Supervised TB therapy and CD4 cell count measurements followed national recommendations for 91% and 74% of patients, respectively. At least 73% of patients started ART before completing TB therapy. Compared with patients who had previous HIV diagnoses, patients with new HIV diagnoses started ART later and had lower CD4 cell counts and higher viral loads at TB diagnosis. Conclusions. Although most HIV/TB patients received the recommended treatment, half had new HIV diagnoses. Compared with patients who had previous HIV diagnoses, patients with new HIV diagnoses had greater immunosuppression at TB diagnosis. A new diagnosis indicates that HIV could have been diagnosed earlier and ART or treatment for latent TB infection could have been initiated to prevent TB development.

AB - Objective. National guidelines highlight the roles of early HIV diagnosis and effective comanagement for HIV and tuberculosis (TB) to prevent mortality and morbidity from HIV-related TB. We assessed HIV diagnosis timing and HIV/TB comanagement for California HIV/TB patients. Methods. We reviewed and analyzed public health charts for California HIV/TB patients reported during 2008. HIV diagnoses fewer than three months before TB diagnosis were considered new HIV diagnoses. We determined the proportion of patients with new HIV diagnoses, risk factors for new HIV diagnoses, and proportion of patients receiving recommended CD4 cell count measurements, supervised TB therapy, and antiretroviral therapy (ART). Results. Of 130 HIV/TB patients, 51% had new HIV diagnoses. Foreign-born patients were more likely than U.S.-born patients to have new HIV diagnoses. Supervised TB therapy and CD4 cell count measurements followed national recommendations for 91% and 74% of patients, respectively. At least 73% of patients started ART before completing TB therapy. Compared with patients who had previous HIV diagnoses, patients with new HIV diagnoses started ART later and had lower CD4 cell counts and higher viral loads at TB diagnosis. Conclusions. Although most HIV/TB patients received the recommended treatment, half had new HIV diagnoses. Compared with patients who had previous HIV diagnoses, patients with new HIV diagnoses had greater immunosuppression at TB diagnosis. A new diagnosis indicates that HIV could have been diagnosed earlier and ART or treatment for latent TB infection could have been initiated to prevent TB development.

UR - http://www.scopus.com/inward/record.url?scp=84894267771&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84894267771&partnerID=8YFLogxK

M3 - Article

C2 - 24587552

AN - SCOPUS:84894267771

VL - 129

SP - 170

EP - 177

JO - Public Health Reports

JF - Public Health Reports

SN - 0033-3549

IS - 2

ER -