The prevalence of HIV in our study population of hospitalized TB patients was 3.3%, which is lower than the national estimate of the HIV-TB coinfectiv-ity rate of 10% published by the Centers for Disease Control and Prevention. This finding may be due to a tendency to list HIV as the primary diagnosis when TB and HIV were coincident. In fact, this appears to be a plausible explanation, as the prevalence of HIV-TB coinfectivity reached 11.3% when we included patients with a primary diagnosis of HIV and a secondary diagnosis of TB. We focused on TB as a primary diagnosis in order to capture outcomes that are most likely attributable to TB illness. Nevertheless, in a secondary analysis (data not presented) we calculated the mortality rate of patients with a primary diagnosis of HIV and a secondary diagnosis of TB to assess whether they had different mortality rates than those patients in our study. The mortality rate was 4.8%, which is similar to that for patients with a primary diagnosis of TB. Thus, we do not believe that including these patients in our analysis would have changed our results significantly. there
We have shown that TB is a disease that disproportionately affects minority populations in the United States. In many illnesses for which there are racial disparities in outcome, there is concern about the quality of care. For instance, minorities are less likely to undergo invasive cardiac procedures. However, our study showed that, once hospitalized for TB, minority patients had similar mortality outcomes as whites. These results should provide some optimism concerning potential racial disparities in the care of patients with TB, and they suggest that there may not be large differences in the hospital care of TB patients of different races and ethnicities.