Risk of tuberculosis after initiation of antiretroviral therapy among persons with HIV in Europe.

Johansen, Isik S; Roen, Ashley; Kraef, Christian; Martín-Iguacel, Raquel; Nemeth, Johannes; Fenner, Lukas; Zangerle, Robert; Llibre, Josep M; Miller, Robert F; Suarez, Isabelle; de Wit, Stephane; Wit, Ferdinand; Mussini, Christina; Saracino, Annalisa; Canetti, Diana; Volny-Anne, Alain; Jaschinski, Nadine; Neesgaard, Bastian; Ryom, Lene; Peters, Lars; ... (2024). Risk of tuberculosis after initiation of antiretroviral therapy among persons with HIV in Europe. International journal of infectious diseases, 147, p. 107199. Elsevier 10.1016/j.ijid.2024.107199

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OBJECTIVES

Tuberculosis (TB) risk after initiation of antiretroviral treatment (ART) is not well described in a European setting, with an average TB incidence of 25/105 in the background population.

METHODS

We included all adult persons with HIV starting ART in the RESPOND cohort between 2012 and 2020. TB incidence rates (IR) were assessed for consecutive time intervals post-ART initiation. Risk factors for TB within 6 months from ART initiation were evaluated using Poisson regression models.

RESULTS

Among 8441 persons with HIV, who started ART, 66 developed TB during 34,239 person-years of follow-up [PYFU], corresponding to 1.87/1000 PYFU (95% confidence interval [CI]: 1.47-2.37). TB IR was highest in the first 3 months after ART initiation (14.41/1000 PY (95%CI 10.08-20.61]) and declined at 3-6, 6-12, and >12 months post-ART initiation (5.89 [95%CI 3.35-10.37], 2.54 [95%CI 1.36-4.73] and 0.51 [95%CI 0.30-0.86]), respectively. Independent risk factors for TB within the first 6 months after ART initiation included follow-up in Northern or Eastern Europe region, African origin, baseline CD4 count <200 cells/mm3, HIV RNA >100,000 copies/mL, injecting drug use and heterosexual transmission.

CONCLUSIONS

TB IR was highest in the first 3 months post-ART initiation and was associated with baseline risk factors, highlighting the importance of thorough TB risk assessment at ART initiation.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Pre-clinic Human Medicine > Institute of Social and Preventive Medicine (ISPM)

UniBE Contributor:

Fenner, Lukas

Subjects:

600 Technology > 610 Medicine & health
300 Social sciences, sociology & anthropology > 360 Social problems & social services

ISSN:

1878-3511

Publisher:

Elsevier

Language:

English

Submitter:

Pubmed Import

Date Deposited:

15 Aug 2024 10:51

Last Modified:

04 Oct 2024 00:15

Publisher DOI:

10.1016/j.ijid.2024.107199

PubMed ID:

39142437

Uncontrolled Keywords:

AIDS ART TB/HIV incidence

BORIS DOI:

10.48350/199717

URI:

https://boris.unibe.ch/id/eprint/199717

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