BACKGROUND: It is not known whether the risk of active tuberculosis disease varies with the length of time that individuals are infected with HIV. OBJECTIVE: To study how, independently of CD4 T cell count, the risk of tuberculosis varies with the duration of HIV infection. METHODS: Using Poisson regression analysis, the incidence of and risk factors for tuberculosis were studied in 683 injecting drug users (IDU) with a documented date of HIV seroconversion followed in seven cohorts in six European countries until 1998. RESULTS: Overall incidence was 11.5/1000 person-years. Adjusted for CD4 T cell count and geographic region, the risk ratio (RR) for tuberculosis (both pulmonary and extrapulmonary), compared with the first 3 years of HIV infection, was 2.8 for years 4 to 6 of HIV infection [95% confidence interval (CI), 1.3-6.3], 1.2 for year 7 to 9 (95% CI, 0.3-4.2) and 4.6 after 9 years (95% CI, 1.4-15.0). The adjusted RR for geographic region was 13.1 (95% CI, 4.3-40.0) for Amsterdam and 15.8 (95% CI, 4.8-52.0) for the Valencian region of Spain compared with all other sites combined. CONCLUSION: The risk of tuberculosis is increased relatively early in HIV infection (year 4 to 6) and also later (after year 9) with possibly a relatively silent period between. As expected, IDU in Southern Europe have a substantially higher risk of tuberculosis than IDU in Northern and Central Europe. Amsterdam forms an exception for Northern Europe, with very high incidence rates.
BACKGROUND: It is not known whether the risk of active tuberculosis disease varies with the length of time that individuals are infected with HIV. OBJECTIVE: To study how, independently of CD4 T cell count, the risk of tuberculosis varies with the duration of HIV infection. METHODS: Using Poisson regression analysis, the incidence of and risk factors for tuberculosis were studied in 683 injecting drug users (IDU) with a documented date of HIV seroconversion followed in seven cohorts in six European countries until 1998. RESULTS: Overall incidence was 11.5/1000 person-years. Adjusted for CD4 T cell count and geographic region, the risk ratio (RR) for tuberculosis (both pulmonary and extrapulmonary), compared with the first 3 years of HIV infection, was 2.8 for years 4 to 6 of HIV infection [95% confidence interval (CI), 1.3-6.3], 1.2 for year 7 to 9 (95% CI, 0.3-4.2) and 4.6 after 9 years (95% CI, 1.4-15.0). The adjusted RR for geographic region was 13.1 (95% CI, 4.3-40.0) for Amsterdam and 15.8 (95% CI, 4.8-52.0) for the Valencian region of Spain compared with all other sites combined. CONCLUSION: The risk of tuberculosis is increased relatively early in HIV infection (year 4 to 6) and also later (after year 9) with possibly a relatively silent period between. As expected, IDU in Southern Europe have a substantially higher risk of tuberculosis than IDU in Northern and Central Europe. Amsterdam forms an exception for Northern Europe, with very high incidence rates.
Authors: Katharine A Fox; Daniela E Kirwan; Ashley M Whittington; Nitya Krishnan; Brian D Robertson; Robert H Gilman; José W López; Shivani Singh; Joanna C Porter; Jon S Friedland Journal: Am J Respir Crit Care Med Date: 2018-07-15 Impact factor: 21.405
Authors: M Majigo; G Somi; A Joachim; J Manyahi; J Nondi; V Sambu; A Rwebembera; N Makyao; A Ramadhani; W Maokola; J Todd; M I Matee Journal: Trop Med Health Date: 2020-09-04
Authors: Eduardo Ticona; Luz Huaroto; Daniela E Kirwan; Milagros Chumpitaz; César V Munayco; Mónica Maguiña; Marco A Tovar; Carlton A Evans; Roderick Escombe; Robert H Gilman Journal: Am J Trop Med Hyg Date: 2016-09-12 Impact factor: 2.345