Association of highly active antiretroviral treatment with incident tuberculosis in people living with HIV/AIDS.

Autor: Yen YF; Section of Infectious Diseases, Taipei City Hospital, Taipei, Taiwan; School of Medicine, National Yang-Ming University, Taipei, Taiwan; Center for Infectious Disease and Cancer Research, Kaohsiung Medical University, Kaohsiung, Taiwan; Department of Health Care Management, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan., Jen IA; Department and Institute of Public Health, National Yang-Ming University, Taipei, Taiwan., Chuang PH; Taipei Association of Health and Welfare Data Science, Taipei, Taiwan., Chen M; Department of Urology, Mackay Memorial Hospital, Taipei, Taiwan; Department of Cosmetic Applications and Management, Mackay Junior College of Medicine, Nursing and Management, Taipei, Taiwan., Lan YC; Department of Health Risk Management, China Medical University, Taichung, Taiwan., Lee CY; Division of Infectious Diseases, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan., Arthur Chen YM; Center for Infectious Disease and Cancer Research, Kaohsiung Medical University, Kaohsiung, Taiwan; Department of Microbiology and Institute of Medical Research, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan. Electronic address: arthur@kmu.edu.tw.
Jazyk: angličtina
Zdroj: Annals of epidemiology [Ann Epidemiol] 2018 Dec; Vol. 28 (12), pp. 886-892.e3. Date of Electronic Publication: 2018 Mar 28.
DOI: 10.1016/j.annepidem.2018.03.011
Abstrakt: Purpose: To determine the short-term and long-term effects of highly active antiretroviral therapy (HAART) on incident tuberculosis (TB) in people living with HIV/AIDS (PLWHA).
Methods: From 2000 to 2012, we identified adult PLWHA from Taiwan Centers for Disease Control HIV Surveillance System. All PLWHA were followed up until December 31, 2012, and observed for TB occurrence. Time-dependent Cox proportional hazards models were used to determine the short-term and long-term effects of HAART on incident TB.
Results: Of 20,072 PLWHA, 628 (3.13%) had incident TB, corresponding to an incident rate of 701/100,000 person-years. After adjusting for potential confounders, PLWHA receiving HAART were more likely to develop TB than those not receiving the drugs (adjusted hazard ratio [AHR] 1.56; 95% confidence interval [CI] 1.18-2.05). While the short-term and long-term effects of HAART on incident TB were considered, HAART was a risk factor for TB development within the first 90 days (AHR 6.06; 95% CI 4.58-8.01) and between 90 and 180 days of treatment (AHR 1.80; 95% CI 1.11-2.94) but was a protective factor after 180 days of HAART use (AHR 0.51; 95% CI 0.39-0.66).
Conclusions: HAART is a risk factor for the development of TB in the short term but a protective factor in the long term.
(Copyright © 2018 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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