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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; Garges, Harmony P; Rooney, James F; Podlekareva, Daria; Mocroft, Amanda; Kirk, Ole.
Affiliation
  • Johansen IS; Department of Infectious Diseases, Odense University Hospital, University of Southern Denmark, Odense, Denmark; Research Unit of Infectious Diseases, Department of Clinical Research, University of Southern Denmark, Odense, Denmark. Electronic address: isik.somuncu.johansen@rsyd.dk.
  • Roen A; Centre for Clinical Research, Epidemiology, Modelling and Evaluation (CREME), Institute for Global Health, University College London, London, UK; CHIP, Centre of Excellence for Health, Immunity and Infections, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.
  • Kraef C; CHIP, Centre of Excellence for Health, Immunity and Infections, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark; Department of Infectious Diseases, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.
  • Martín-Iguacel R; Department of Infectious Diseases, Odense University Hospital, University of Southern Denmark, Odense, Denmark; Research Unit of Infectious Diseases, Department of Clinical Research, University of Southern Denmark, Odense, Denmark.
  • Nemeth J; Swiss HIV Cohort Study (SHCS), University of Zurich, Zurich, Switzerland.
  • Fenner L; Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland.
  • Zangerle R; Austrian HIV Cohort Study (AHIVCOS), Medizinische Universität Innsbruck, Innsbruck, Austria.
  • Llibre JM; Infectious Diseases Division, University Hospital Germans Trias, Badalona, Spain; Fight Infections Foundation, Badalona, Spain.
  • Miller RF; The Royal Free HIV Cohort Study, Royal Free Hospital, University College London, London, UK.
  • Suarez I; Department of Internal Medicine, Medical Faculty and University Hospital Cologne, University of Cologne, Cologne, Germany.
  • de Wit S; CHU Saint-Pierre, Centre de Recherche en Maladies Infectieuses a.s.b.l., Brussels, Belgium.
  • Wit F; AIDS Therapy Evaluation in the Netherlands (ATHENA) Cohort, HIV Monitoring Foundation, Amsterdam, the Netherlands.
  • Mussini C; Modena HIV Cohort, Università degli Studi di Modena, Modena, Italy.
  • Saracino A; Italian Cohort Naive Antiretrovirals (ICONA), ASST Santi Paolo e Carlo, Milano, Italy.
  • Canetti D; San Raffaele Scientific Institute, Università Vita-Salute San Raffaele, Milano, Italy.
  • Volny-Anne A; European AIDS Treatment Group (EATG), Brussels, Belgium.
  • Jaschinski N; CHIP, Centre of Excellence for Health, Immunity and Infections, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.
  • Neesgaard B; CHIP, Centre of Excellence for Health, Immunity and Infections, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.
  • Ryom L; CHIP, Centre of Excellence for Health, Immunity and Infections, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark; Dept of Infectious Diseases, Hvidovre Hospital, University of Copenhagen, Denmark; Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark.
  • Peters L; CHIP, Centre of Excellence for Health, Immunity and Infections, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.
  • Garges HP; ViiV Healthcare, RTP, NC, USA.
  • Rooney JF; Gilead Sciences, Foster City, CA, USA.
  • Podlekareva D; CHIP, Centre of Excellence for Health, Immunity and Infections, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark; Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark; Department of Respiratory Medicine and Infectious Disease, Copenhagen University Hospital, Bi
  • Mocroft A; Centre for Clinical Research, Epidemiology, Modelling and Evaluation (CREME), Institute for Global Health, University College London, London, UK; CHIP, Centre of Excellence for Health, Immunity and Infections, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.
  • Kirk O; Research Unit of Infectious Diseases, Department of Clinical Research, University of Southern Denmark, Odense, Denmark; CHIP, Centre of Excellence for Health, Immunity and Infections, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark; Department of Infectious Diseases, Rigshospitalet, Un
Int J Infect Dis ; 147: 107199, 2024 Oct.
Article in En | MEDLINE | ID: mdl-39142437
ABSTRACT

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.
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Full text: 1 Collection: 01-internacional Database: MEDLINE Main subject: Tuberculosis / HIV Infections Limits: Adult / Female / Humans / Male / Middle aged Country/Region as subject: Europa Language: En Journal: Int J Infect Dis Year: 2024 Document type: Article

Full text: 1 Collection: 01-internacional Database: MEDLINE Main subject: Tuberculosis / HIV Infections Limits: Adult / Female / Humans / Male / Middle aged Country/Region as subject: Europa Language: En Journal: Int J Infect Dis Year: 2024 Document type: Article