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Diagnosis of latent tuberculosis infection is associated with reduced HIV viral load and lower risk for opportunistic infections in people living with HIV.
Kusejko, Katharina; Günthard, Huldrych F; Olson, Gregory S; Zens, Kyra; Darling, Katharine; Khanna, Nina; Furrer, Hansjakob; Vetter, Pauline; Bernasconi, Enos; Vernazza, Pietro; Hoffmann, Matthias; Kouyos, Roger D; Nemeth, Johannes.
Affiliation
  • Kusejko K; Division of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich, Zurich, Switzerland.
  • Günthard HF; Institute of Medical Virology, University of Zurich, Zurich, Switzerland.
  • Olson GS; Division of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich, Zurich, Switzerland.
  • Zens K; Institute of Medical Virology, University of Zurich, Zurich, Switzerland.
  • Darling K; Seattle Children's Research Institute, Seattle, Washington, United States of America.
  • Khanna N; Institute of Experimental Immunology, University of Zurich, Zurich, Switzerland.
  • Furrer H; Department of Infectious Diseases, University Hospital Lausanne, Lausanne, Switzerland.
  • Vetter P; Infectious Diseases and Hospital Epidemiology, University Hospital Basel, Basel, Switzerland.
  • Bernasconi E; Department of Infectious Diseases, Bern University Hospital, University of Bern, Bern, Switzerland.
  • Vernazza P; Division of Infectious Diseases, Geneva University Hospitals, Geneva, Switzerland.
  • Hoffmann M; Division of Infectious Diseases, Regional Hospital Lugano, Lugano, Switzerland.
  • Kouyos RD; Division of Infectious Diseases, Cantonal Hospital St Gallen, St. Gallen, Switzerland.
  • Nemeth J; Division of Infectious Diseases, Cantonal Hospital Olten, Olten, Switzerland.
PLoS Biol ; 18(12): e3000963, 2020 12.
Article in En | MEDLINE | ID: mdl-33284802
Approximately 28% of the human population have been exposed to Mycobacterium tuberculosis (MTB), with the overwhelming majority of infected individuals not developing disease (latent TB infection (LTBI)). While it is known that uncontrolled HIV infection is a major risk factor for the development of TB, the effect of underlying LTBI on HIV disease progression is less well characterized, in part because longitudinal data are lacking. We sorted all participants of the Swiss HIV Cohort Study (SHCS) with at least 1 documented MTB test into one of the 3 groups: MTB uninfected, LTBI, or active TB. To detect differences in the HIV set point viral load (SPVL), linear regression was used; the frequency of the most common opportunistic infections (OIs) in the SHCS between MTB uninfected patients, patients with LTBI, and patients with active TB were compared using logistic regression and time-to-event analyses. In adjusted models, we corrected for baseline demographic characteristics, i.e., HIV transmission risk group and gender, geographic region, year of HIV diagnosis, and CD4 nadir. A total of 13,943 SHCS patients had at least 1 MTB test documented, of whom 840 (6.0%) had LTBI and 770 (5.5%) developed active TB. Compared to MTB uninfected patients, LTBI was associated with a 0.24 decreased log HIV SPVL in the adjusted model (p < 0.0001). Patients with LTBI had lower odds of having candida stomatitis (adjusted odds ratio (OR) = 0.68, p = 0.0035) and oral hairy leukoplakia (adjusted OR = 0.67, p = 0.033) when compared to MTB uninfected patients. The association of LTBI with a reduced HIV set point virus load and fewer unrelated infections in HIV/TB coinfected patients suggests a more complex interaction between LTBI and HIV than previously assumed.
Subject(s)

Full text: 1 Collection: 01-internacional Health context: 2_ODS3 / 3_ND Database: MEDLINE Main subject: HIV Infections / Latent Tuberculosis Type of study: Diagnostic_studies / Etiology_studies / Incidence_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Limits: Adult / Female / Humans / Male / Middle aged Language: En Journal: PLoS Biol Year: 2020 Document type: Article

Full text: 1 Collection: 01-internacional Health context: 2_ODS3 / 3_ND Database: MEDLINE Main subject: HIV Infections / Latent Tuberculosis Type of study: Diagnostic_studies / Etiology_studies / Incidence_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Limits: Adult / Female / Humans / Male / Middle aged Language: En Journal: PLoS Biol Year: 2020 Document type: Article