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The prevalence of hepatitis C virus (HCV) infection and associated risk factors in an inner city sexually active heterosexual population participating in a prospective study for the evaluation of heterosexual transmission of human immunodeficiency virus type-1 (HIV-1) were examined. Individuals with prior history of injection drug use or receipt of blood products were excluded from the study. Of 571 participants, 25 (4.4%) were seropositive for HCV, 39 (7%) for HIV, and 125 (22%) for hepatitis B virus (HBV). Multivariate analysis revealed that those with more than ten heterosexual partners in the past 5 years (OR = 3.7; 95% CI = 1.3, 10.2; P = 0.01), engaging in sexual practices more than once per week (OR = 3.3; 95% CI = 1.1, 10.1; P = 0.04), with antibody to hepatitis B core (HBc) antigen (OR = 2.9; 95% CI = 1.1, 7.4; P = 0.03), and antibody to HIV-1 (OR = 5.8; 95% CI = 1.9; 17.6; P = 0.002) were independently associated with HCV infection. These findings suggest that heterosexual transmission of HCV may occur in an inner city sexually active heterosexual population. more...

Objective: To evaluate a nosocomial outbreak of tuberculosis caused by multiple-drug-resistant bacilli among patients with tuberculosis and HIV infection., Design: A case-control study., Patients: Patients with HIV infection and culture-proven tuberculosis., Measurements: Patient characteristics, date of diagnoses of HIV infection and disease, date of diagnosis of tuberculosis, Mycobacterium tuberculosis susceptibility results, and medical center contact., Results: Sixty-two patients who had tuberculosis caused by multiple-drug-resistant bacilli (cases) and 55 patients who had tuberculosis caused by susceptible or single-drug-resistant bacilli (controls) were identified. Controls were more likely to be black (odds ratio, 0.4; 95% CI, 0.2 to 0.9) or Haitian (odds ratio, 0.2; CI, 0.1 to 0.6) compared with cases, who were more likely to be homosexual men (odds ratio, 2.9; CI, 1.3 to 6.4). Forty-four cases (71%) had previous contact with an HIV clinic compared with 15 controls (27%) (P less than 0.0001). Cases were more likely to have had AIDS (odds ratio, 7.7; CI, 1.5 to 53.7), to have been hospitalized on an HIV ward (odds ratio, 8.3; CI, 2.3 to 29.7), to have been seen in an HIV clinic (odds ratio, 7.8; CI, 3.4 to 18.1), to have received intravenous therapy in an HIV clinic (odds ratio, 13.0; CI, 4.6 to 37.0), or to have received inhalation pentamidine in an HIV clinic before a diagnosis of tuberculosis was made. Multiple logistic regression analysis showed that a diagnosis of AIDS (odds ratio, 11.2; CI, 3.1 to 40.6) and HIV clinic visits (odds ratio, 13.0; CI, 2.7 to 63.7) before a diagnosis of tuberculosis were significantly associated with tuberculosis caused by multiple-drug-resistant bacilli. Using susceptibility patterns and appointment dates, we found that 22 cases had previous contact with a person who had tuberculosis caused by multiple-drug-resistant bacilli in the HIV clinic., Conclusions: Nosocomial transmission of M. tuberculosis from other HIV-infected patients with tuberculosis caused by multiple-drug-resistant bacilli can occur. These findings have serious public health implications and demand strict adherence to acid-fast bacilli isolation precautions. more...