Undernotification of tuberculosis in patients with AIDS

The purpose of this study was to establish the extent of undernotification of tuberculosis in AIDS patients resident in 2 inner London local authorities. For residents of the 2 authorities, statutory notifications of tuberculosis between 1986 and 1992 were compared, using sounder codes of surnames, sex and year of birth, with AIDS cases reported to the Public Health Laboratory Service (PHLS) AIDS Centre during the same period where TB had been recorded on the AIDS report form. In 36 of 613 AIDS cases reported as residents of the 2 authorities tuberculosis was recorded on the AIDS report form. Matching revealed that only 2 (6%) of these cases had been notified to the local authority. These results highlight the need to resolve the dilemma between concerns about patient confidentiality and the statutory requirement to notify tuberculosis so that clinical management of contacts can be undertaken and the true impact of HIV infection on the incidence of tuberculosis in the UK can be elucidated.