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Title

Tuberculosis among HIV-positive patients across Europe: changes over time and risk factors

Authors

Kruk A, Bannister W, Podlekareva D

Network Affiliation

Other

Organization

 

Journal Name

AIDS

Publication Date

5/21/2011

PubMed Search

http://www.ncbi.nlm.nih.gov/pubmed?term=Tuberculosis%20among%20HIV-positive%20patients%20across%20Europe%3A%20changes%20over%20time%20and%20risk%20factors.

Link to full-text

 

PMID

21610489

Abstract

OBJECTIVE:

To describe temporal changes in the incidence rate (IR) of tuberculosis (TB) (pulmonary or extrapulmonary) among HIV-positive patients in Western Europe (WE) and risk factors of TB across Europe.

METHODS:

Poisson regression models were used to determine temporal changes in IR of TB among 11,952 patients from WE (1994-2010), and to assess risk factors for TB among 12,673 patients from across Europe with follow-up after 2001.

RESULTS:

277 TB events occurred during 84,221 person-years of follow-up (PYFU) in WE. The IR declined from 1.91 (95% confidence interval: 1.51-2.37) in 1994-1995 to 0.12 (0.07-0.21) /100 PYFU in 2002-2003, and remained stable thereafter.After January 2001, 159 TB events were diagnosed; 65 cases in WE and 94 cases in Eastern Europe (EE); resulting in IRs of 0.12 (0.09-0.14) and 0.65 (0.52-0.79)/100 PYFU, respectively. In multivariable analysis, IR of TB was approximately four-fold higher in EE compared with WE (IRR: 4.25 (2.78-6.49); p < 0.001). There were no significant temporal changes after 2001 and risk factors did not differ significantly between EE and WE. Lower CD4 cell counts, higher HIV-RNA levels, male gender, intravenous drug usage and African origin were all associated with higher risk of TB.

CONCLUSION:

IRs of TB in WE remained at a very low and stable level since 2001. After 2001, patients in EE were at substantially higher risk of TB than in WE. TB is of great concern in HIV-positive patients, especially in areas with high TB prevalence, high levels of immigration from TB-endemic regions, and with suboptimal access to combination antiretroviral therapy.

Keywords

 

Topic

TB

Attachments

Created at 7/11/2011 1:03 PM by Mooney, Jessica L
Last modified at 7/11/2011 1:03 PM by Mooney, Jessica L