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Adult human immunodeficiency virus (HIV) clinics affiliated to the University of Cape Town, South Africa.

To assess the impact of tuberculosis on HIV-1 disease progression in an area with high tuberculosis prevalence and minimal antiretroviral therapy use.

Prospective patient cohort study.

Age, race, risk status, CD4+ T-lymphocyte count, history of AIDS, prophylactic co-trimoxazole and antiretroviral therapy were controlled for in a time-dependent Cox proportional hazards regression model.

Tuberculosis fulfilling the case definition developed in 158/609 patients in the 5-year observation period. Tuberculosis was associated with an increased risk of AIDS (adjusted risk ratio [RR] = 1.60, 95% confidence interval [CI] 1.08–2.41; P = 0.02) and death (adjusted RR = 2.16, 95%CI 1.29–3.59; P = 0.003). In a stratified analysis, the increased mortality associated with …