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Latent infection in HIV-positive refugees and other immigrants in Australia

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To the Editor: Refugees and other immigrants may carry latent infections not endemic to Australia. Immunocompromised people, including those living with HIV, are at particular risk of reactivation of such infections.1 Screening for schistosomiasis and strongyloidiasis in patients with HIV is not currently recommended by Australian guidelines2 or the United States guidelines that they reference;3 however, it is recommended by those of the United Kingdom.4

We sought to determine the prevalence of latent tuberculosis (TB), Schistosoma spp. and Strongyloides stercoralis in a cohort of people living with HIV attending a tertiary care hospital in Melbourne. The study received approval from our research ethics committee. Between 1 January 1990 and 6 March 2014, a total of 500 patients were under the care of the HIV clinic. These patients were included in a retrospective analysis of data extracted from existing pathology and administrative databases.

Mean age at presentation was 38 years, median length of time attending the clinic was 24.5 months (range, 1–289 months), and 383 patients (77%) were male. Two hundred and twenty patients (44%) were born outside Australia in over 60 different countries. Fifty-eight…