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Letters |

Drug Abuse, HIV Infection, and Tuberculosis

Lawrence S. Brown Jr, MD, MPH; Charles P. Felton, MD
JAMA. 1989;262(5):615-616. doi:10.1001/jama.1989.03430050025014.
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To the Editor.—  The recent article by Braun and colleagues1 and the accompanying editorial by Drs Snider and Hutton2 are especially timely in focusing on the need for appropriate tuberculosis-control measures in correctional facilities. The relationship between drug abuse and tuberculosis was another finding of the study by Braun et al and confirms previous reports.3,4 The significance of the drug abuse— tuberculosis association is especially intriguing, given the recent trends of the concurrent rise of tuberculosis and acquired immunodeficiency syndrome case reporting in the United States.The increase in case reports of tuberculosis has been explained by most investigators as human immunodeficiency virus (HIV)—associated immunosuppression resulting in activation of latent tuberculosis infection.4However, new infection has not been unequivocally dismissed as a possible contribution. More importantly, very little information is available about the efficacy of tuberculosis preventive or therapeutic regimens in persons with HIV infection or


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