OBJECTIVE: To estimate the impact of antiretroviral therapy (ART) on the incidence of recurrent tuberculosis (TB) in an African population. DESIGN: A long-term population cohort in Karonga District, northern Malawi. METHODS: Patients who had completed treatment for laboratory-confirmed TB diagnosed since 1996 were visited annually to record vital status, ART use and screen for TB. Survival analysis estimated the effect of HIV/ART status at completion of treatment on mortality and recurrence. Analyses were stratified by time since treatment completion to estimate the effects on relapse (predominates during first year) and reinfection disease (predominates later). RESULTS: Among 1133 index TB cases contributing 4353 person-years of follow-up, there were 307 deaths and 103 laboratory-confirmed recurrences (recurrence rate 4.6 per 100 person-years). Half the recurrences occurred in the first year since completing treatment. HIV infection increased the recurrence rate [rate ratio adjusted for age, sex, period and TB type 2.69, 95% confidence interval (CI) 1.69-4.26], but with less effect in the first year (adjusted rate ratio 1.71, 95% CI 0.87-3.35) than subsequently (adjusted rate ratio 4.2, 95% CI 2.16-8.15). Recurrence rates on ART were intermediate between those of HIV-negative individuals and HIV-positive individuals without ART. Compared with HIV-positive individuals without ART, the adjusted rate ratio was 0.74 (95% CI 0.27-2.06) in the first year, and 0.43 (95% CI 0.11-1.73) later. CONCLUSION: The increased incidence of TB recurrence observed in HIV-positive patients appeared to be reduced by ART. The effects are mostly on later (likely reinfection) disease so the impact of ART on reducing recurrence will be highest in high TB incidence settings.
OBJECTIVE: To estimate the impact of antiretroviral therapy (ART) on the incidence of recurrent tuberculosis (TB) in an African population. DESIGN: A long-term population cohort in Karonga District, northern Malawi. METHODS:Patients who had completed treatment for laboratory-confirmed TB diagnosed since 1996 were visited annually to record vital status, ART use and screen for TB. Survival analysis estimated the effect of HIV/ART status at completion of treatment on mortality and recurrence. Analyses were stratified by time since treatment completion to estimate the effects on relapse (predominates during first year) and reinfection disease (predominates later). RESULTS: Among 1133 index TB cases contributing 4353 person-years of follow-up, there were 307 deaths and 103 laboratory-confirmed recurrences (recurrence rate 4.6 per 100 person-years). Half the recurrences occurred in the first year since completing treatment. HIV infection increased the recurrence rate [rate ratio adjusted for age, sex, period and TB type 2.69, 95% confidence interval (CI) 1.69-4.26], but with less effect in the first year (adjusted rate ratio 1.71, 95% CI 0.87-3.35) than subsequently (adjusted rate ratio 4.2, 95% CI 2.16-8.15). Recurrence rates on ART were intermediate between those of HIV-negative individuals and HIV-positive individuals without ART. Compared with HIV-positive individuals without ART, the adjusted rate ratio was 0.74 (95% CI 0.27-2.06) in the first year, and 0.43 (95% CI 0.11-1.73) later. CONCLUSION: The increased incidence of TB recurrence observed in HIV-positive patients appeared to be reduced by ART. The effects are mostly on later (likely reinfection) disease so the impact of ART on reducing recurrence will be highest in high TB incidence settings.
Authors: Aditya Sharma; Andrew Hill; Ekaterina Kurbatova; Martie van der Walt; Charlotte Kvasnovsky; Thelma E Tupasi; Janice C Caoili; Maria Tarcela Gler; Grigory V Volchenkov; Boris Y Kazennyy; Olga V Demikhova; Jaime Bayona; Carmen Contreras; Martin Yagui; Vaira Leimane; Sang Nae Cho; Hee Jin Kim; Kai Kliiman; Somsak Akksilp; Ruwen Jou; Julia Ershova; Tracy Dalton; Peter Cegielski Journal: Lancet Infect Dis Date: 2017-05-09 Impact factor: 25.071
Authors: Y F van der Heijden; F Karim; T Chinappa; G Mufamadi; L Zako; B E Shepherd; F Maruri; M-Y S Moosa; T R Sterling; A S Pym Journal: Int J Tuberc Lung Dis Date: 2018-08-01 Impact factor: 2.373
Authors: José Afonso Guerra-Assunção; Rein M G J Houben; Amelia C Crampin; Themba Mzembe; Kim Mallard; Francesc Coll; Palwasha Khan; Louis Banda; Arthur Chiwaya; Rui P A Pereira; Ruth McNerney; David Harris; Julian Parkhill; Taane G Clark; Judith R Glynn Journal: J Infect Dis Date: 2014-10-21 Impact factor: 5.226
Authors: Marcos C Schechter; Destani Bizune; Michelle Kagei; David P Holland; Carlos Del Rio; Aliya Yamin; Omar Mohamed; Alawode Oladele; Yun F Wang; Paulina A Rebolledo; Susan M Ray; Russell R Kempker Journal: Open Forum Infect Dis Date: 2018-03-21 Impact factor: 3.835
Authors: Christopher J L Murray; Katrina F Ortblad; Caterina Guinovart; Stephen S Lim; Timothy M Wolock; D Allen Roberts; Emily A Dansereau; Nicholas Graetz; Ryan M Barber; Jonathan C Brown; Haidong Wang; Herbert C Duber; Mohsen Naghavi; Daniel Dicker; Lalit Dandona; Joshua A Salomon; Kyle R Heuton; Kyle Foreman; David E Phillips; Thomas D Fleming; Abraham D Flaxman; Bryan K Phillips; Elizabeth K Johnson; Megan S Coggeshall; Foad Abd-Allah; Semaw Ferede Abera; Jerry P Abraham; Ibrahim Abubakar; Laith J Abu-Raddad; Niveen Me Abu-Rmeileh; Tom Achoki; Austine Olufemi Adeyemo; Arsène Kouablan Adou; José C Adsuar; Emilie Elisabet Agardh; Dickens Akena; Mazin J Al Kahbouri; Deena Alasfoor; Mohammed I Albittar; Gabriel Alcalá-Cerra; Miguel Angel Alegretti; Zewdie Aderaw Alemu; Rafael Alfonso-Cristancho; Samia Alhabib; Raghib Ali; Francois Alla; Peter J Allen; Ubai Alsharif; Elena Alvarez; Nelson Alvis-Guzman; Adansi A Amankwaa; Azmeraw T Amare; Hassan Amini; Walid Ammar; Benjamin O Anderson; Carl Abelardo T Antonio; Palwasha Anwari; Johan Arnlöv; Valentina S Arsic Arsenijevic; Ali Artaman; Rana J Asghar; Reza Assadi; Lydia S Atkins; Alaa Badawi; Kalpana Balakrishnan; Amitava Banerjee; Sanjay Basu; Justin Beardsley; Tolesa Bekele; Michelle L Bell; Eduardo Bernabe; Tariku Jibat Beyene; Neeraj Bhala; Ashish Bhalla; Zulfiqar A Bhutta; Aref Bin Abdulhak; Agnes Binagwaho; Jed D Blore; Berrak Bora Basara; Dipan Bose; Michael Brainin; Nicholas Breitborde; Carlos A Castañeda-Orjuela; Ferrán Catalá-López; Vineet K Chadha; Jung-Chen Chang; Peggy Pei-Chia Chiang; Ting-Wu Chuang; Mercedes Colomar; Leslie Trumbull Cooper; Cyrus Cooper; Karen J Courville; Benjamin C Cowie; Michael H Criqui; Rakhi Dandona; Anand Dayama; Diego De Leo; Louisa Degenhardt; Borja Del Pozo-Cruz; Kebede Deribe; Don C Des Jarlais; Muluken Dessalegn; Samath D Dharmaratne; Uğur Dilmen; Eric L Ding; Tim R Driscoll; Adnan M Durrani; Richard G Ellenbogen; Sergey Petrovich Ermakov; Alireza Esteghamati; Emerito Jose A Faraon; 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Yousef Saleh Khader; Shams Eldin Ali Hassan Khalifa; Ejaz Ahmed Khan; Young-Ho Khang; Irma Khonelidze; Yohannes Kinfu; Jonas M Kinge; Luke Knibbs; Yoshihiro Kokubo; S Kosen; Barthelemy Kuate Defo; Veena S Kulkarni; Chanda Kulkarni; Kaushalendra Kumar; Ravi B Kumar; G Anil Kumar; Gene F Kwan; Taavi Lai; Arjun Lakshmana Balaji; Hilton Lam; Qing Lan; Van C Lansingh; Heidi J Larson; Anders Larsson; Jong-Tae Lee; James Leigh; Mall Leinsalu; Ricky Leung; Yichong Li; Yongmei Li; Graça Maria Ferreira De Lima; Hsien-Ho Lin; Steven E Lipshultz; Shiwei Liu; Yang Liu; Belinda K Lloyd; Paulo A Lotufo; Vasco Manuel Pedro Machado; Jennifer H Maclachlan; Carlos Magis-Rodriguez; Marek Majdan; Christopher Chabila Mapoma; Wagner Marcenes; Melvin Barrientos Marzan; Joseph R Masci; Mohammad Taufiq Mashal; Amanda J Mason-Jones; Bongani M Mayosi; Tasara T Mazorodze; Abigail Cecilia Mckay; Peter A Meaney; Man Mohan Mehndiratta; Fabiola Mejia-Rodriguez; Yohannes Adama Melaku; Ziad A Memish; Walter Mendoza; Ted R Miller; Edward J Mills; Karzan Abdulmuhsin Mohammad; Ali H Mokdad; Glen Liddell Mola; Lorenzo Monasta; Marcella Montico; Ami R Moore; Rintaro Mori; Wilkister Nyaora Moturi; Mitsuru Mukaigawara; Kinnari S Murthy; Aliya Naheed; Kovin S Naidoo; Luigi Naldi; Vinay Nangia; K M Venkat Narayan; Denis Nash; Chakib Nejjari; Robert G Nelson; Sudan Prasad Neupane; Charles R Newton; Marie Ng; Muhammad Imran Nisar; Sandra Nolte; Ole F Norheim; Vincent Nowaseb; Luke Nyakarahuka; In-Hwan Oh; Takayoshi Ohkubo; Bolajoko O Olusanya; Saad B Omer; John Nelson Opio; Orish Ebere Orisakwe; Jeyaraj D Pandian; Christina Papachristou; Angel J Paternina Caicedo; Scott B Patten; Vinod K Paul; Boris Igor Pavlin; Neil Pearce; David M Pereira; Aslam Pervaiz; Konrad Pesudovs; Max Petzold; Farshad Pourmalek; Dima Qato; Amado D Quezada; D Alex Quistberg; Anwar Rafay; Kazem Rahimi; Vafa Rahimi-Movaghar; Sajjad Ur Rahman; Murugesan Raju; Saleem M Rana; Homie Razavi; Robert Quentin Reilly; Giuseppe Remuzzi; Jan Hendrik Richardus; Luca Ronfani; Nobhojit Roy; Nsanzimana Sabin; Mohammad Yahya Saeedi; Mohammad Ali Sahraian; Genesis May J Samonte; Monika Sawhney; Ione J C Schneider; David C Schwebel; Soraya Seedat; Sadaf G Sepanlou; Edson E Servan-Mori; Sara Sheikhbahaei; Kenji Shibuya; Hwashin Hyun Shin; Ivy Shiue; Rupak Shivakoti; Inga Dora Sigfusdottir; Donald H Silberberg; Andrea P Silva; Edgar P Simard; Jasvinder A Singh; Vegard Skirbekk; Karen Sliwa; Samir Soneji; Sergey S Soshnikov; Chandrashekhar T Sreeramareddy; Vasiliki Kalliopi Stathopoulou; Konstantinos Stroumpoulis; Soumya Swaminathan; Bryan L Sykes; Karen M Tabb; Roberto Tchio Talongwa; Eric Yeboah Tenkorang; Abdullah Sulieman Terkawi; Alan J Thomson; Andrew L Thorne-Lyman; Jeffrey A Towbin; Jefferson Traebert; Bach X Tran; Zacharie Tsala Dimbuene; Miltiadis Tsilimbaris; Uche S Uchendu; Kingsley N Ukwaja; Selen Begüm Uzun; Andrew J Vallely; Tommi J Vasankari; N Venketasubramanian; Francesco S Violante; Vasiliy Victorovich Vlassov; Stein Emil Vollset; Stephen Waller; 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Authors: Monique van Lettow; Richard Bedell; Sonia Maosa; Kenneth Phiri; Adrienne K Chan; Edson Mwinjiwa; Aunex Kwekwesa; Harry Kawonga; Martias Joshua; Anthony D Harries; Joep J van Oosterhout Journal: PLoS One Date: 2015-11-10 Impact factor: 3.240