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Abstract
Emerging Tuberculosis In Italy: What Relationship With HIV Disease?
Manfredi R.1, Sabbatani S.1, Chiodo F.1
Introduction: Tuberculosis (TB) is borne by increasing morbidity-mortality rates,due to changes in epidemiologic profile,atypical presentation,and spread of drug-resistant strains.The recently varied predisposing factors play a key role:advancing age,concomitant illnesses,alcoholism,drug abuse,immigration from endemic regions,and concurrent HIV disease.
Methods: Among 98 consecutive patients (p) with confirmed TB hospitalized since 1996,significant differences were found between the 63 Italian p,and the 35 p coming from outside of Western Europe.
Results: When compared with foreigners,Italian p had a greater frequency of HIV infection/AIDS (31.7% of Italian cases;p<.001),with a predominant pleuro-pulmonary involvement vs with limphnode and/or disseminated one among HIV-infected p vs non-HIV-infected ones (p<.01).Compared with foreigners,Italians showed a higher median age (p<.001),and more frequent and varied underlying disorders (personal or familial history of TB,chronic pulmonary,heart,liver,or kidney disease,diabetes,malignancies,and collagen vascular disease;p<.05),while immigrants had generic risk factors (low income,social-economic problems,cigarette smoke,and drug-alcohol use;p<.05 vs Italians).Our 8-year experience shows that two different patterns of TB may be observed.Italian p are mostly represented by elderly,with underlying diseases and specific risk factors for TB,a more frequent HIV co-infection (and a more common involvement of sites other than lower airways),while immigrants are usually represented by young,otherwise healthy p with predominant lung localizations.
Conclusions: Physician awareness of TB should be improved,especially when high-risk p are of concern (like HIV-infected p),to obtain a rapid diagnosis and cure,and reduce transmission.The epidemiologic-clinical features of our TB p,show a notably distinct disease pattern between Italian and immigrant p,but we cannot exclude that the spread of TB,the continued immigration,and growing predisposing conditions in the general population,may lead to a further increase of diagnoses,especially towards extreme life ages.Surveillance and preventive strategies of screening,diagnosis,therapy,and control of TB need a prompt update,to avoid its spread,due to the merging of risk factors of immigrants,which is expected to represent a health care threaten in inner cities,where the progressive integration of immigrants may meet exposed and vulnerable natives,including HIV-infected p.
The 3rd IAS Conference on HIV Pathogenesis and Treatment
Abstract no.
TuPe7.1C03
Suggested Citation
"ManfrediR., et al.
Emerging Tuberculosis In Italy: What Relationship With HIV Disease?.
Poster Exhibition:
The 3rd IAS Conference on HIV Pathogenesis and Treatment:
Abstract no.
TuPe7.1C03"
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