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Int J Tuberc Lung Dis. 2018 Oct 1;22(10):1216-1219. doi: 10.5588/ijtld.17.0846.

HIV screening of tuberculosis patients in Portugal: what are we missing?

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Pulmonology Department, Centro Hospitalar de Trás-os-Montes e Alto Douro, Vila Real.
Occupational Health, Centro Hospitalar de Vila Nova de Gaia/Espinho Entidade Pública Empresarial (EPE), Vila Nova de Gaia, EPIUnit, Instituto De Saúde Pública Da Universidade Do Porto, Universidade do Porto, Porto.
Faculty of Sciences, University of Porto, Porto, Centre of Mathematics, University of Porto, Porto.
EPIUnit, Instituto De Saúde Pública Da Universidade Do Porto, Universidade do Porto, Porto, Chest Disease Centre, Vila Nova de Gaia, Pulmonology Department, Centro Hospitalar de Vila Nova de Gaia/Espinho EPE, Department of Clinical Epidemiology, Predictive Medicine and Public Health University of Porto Medical School, Porto, Portugal.



Knowledge of human immunodeficiency virus (HIV) status is essential to effectively manage both tuberculosis (TB) and HIV infection. This is why the World Health Organization (WHO) recommends routine HIV testing in all TB patients.


To determine the number of TB patients with unknown HIV status in Portugal and to identify the factors associated with unknown HIV status.


A retrospective study of all TB notifications from 2008 to 2014 in Portugal was conducted. A multiple logistic regression model was used to evaluate the association of sociodemographic and clinical factors with unknown HIV status.


We examined the records of 18 445 patients with TB notification, 2402 of whom (13%) had unknown HIV status. Unknown HIV status was positively associated with age 65 years (adjusted odds ratio [aOR] 1.208, 95%CI 1.037-1.408) and extra-pulmonary TB (aOR 1.381, 95%CI 1.252-1.523), but negatively associated with unemployment (aOR 0.755, 95%CI 0.637-0.895), alcohol dependence (aOR 0.809, 95%CI 0.682-0.959) and drug dependence (aOR 0.566, 95%CI 0.449-0.713).


Risk perception is the most important barrier to complete knowledge of HIV status in TB patients in Portugal. Given the importance of HIV screening in TB patients, every effort should be made to ensure that all TB patients undergo HIV screening.


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