Prevalence and predictors of tuberculosis infection among people living with HIV in a high tuberculosis burden context.

Autor:	Njagi LN; Center for Respiratory Disease Research, Kenya Medical Research Institute, Nairobi, Kenya njagi.lilian@gmail.com.; Department of Medical Microbiology & Immunology, University of Nairobi Faculty of Health Sciences, Nairobi, Kenya., Nduba V; Center for Respiratory Disease Research, Kenya Medical Research Institute, Nairobi, Kenya., Mureithi MW; Department of Medical Microbiology & Immunology, University of Nairobi Faculty of Health Sciences, Nairobi, Kenya., Mecha JO; Department of Clinical Medicine and Therapeutics, University of Nairobi Faculty of Health Sciences, Nairobi, Kenya.
Jazyk:	angličtina
Zdroj:	BMJ open respiratory research [BMJ Open Respir Res] 2023 May; Vol. 10 (1).
DOI:	10.1136/bmjresp-2022-001581
Abstrakt:	Background: Tuberculosis (TB) disease is the leading cause of mortality among people living with HIV (PLHIV). Interferon-gamma release assays (IGRAs) are approved for TB infection ascertainment. However, current IGRA data on the prevalence of TB infection in the context of near-universal access to antiretroviral therapy (ART) and TB preventive therapy (TPT) are lacking. We estimated the prevalence and determinants of TB infection among PLHIV within a high TB and HIV burden context. Methods: This cross-sectional study included data from adult PLHIV age ≥18 years in whom QuantiFERON-TB Gold Plus (QFT-Plus) assay, an IGRA, was performed. TB infection was defined as a positive or indeterminate QFT-Plus test. Participants with TB and those who had previously used TPT were excluded. Regression analysis was performed to identify independent predictors of TB infection. Results: Of 121 PLHIV with QFT-Plus test results, females were 74.4% (90/121), and the mean age was 38.4 (SD 10.8) years. Overall, 47.9% (58/121) were classified as TB infection (QFT-Plus test positive and indeterminate results were 39.7% (48/121) and 8.3% (10/121), respectively). Being obese/overweight (body mass index ≥25 kg/m 2 ; p=0.013, adjusted OR (aOR) 2.90, 95% CI 1.25 to 6.74) and ART usage for >3 years (p=0.013, aOR 3.99, 95% CI 1.55 to 10.28) were independently associated with TB infection. Conclusion: There was a high TB infection prevalence among PLHIV. A longer period of ART and obesity were independently associated with TB infection. The relationship between obesity/overweight and TB infection may be related to ART use and immune reconstitution and requires further investigation. Given the known benefit of test-directed TPT among PLHIV never exposed to TPT, its clinical and cost implications for low and middle-income countries should be explored further. Competing Interests: Competing interests: None declared. (© Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY. Published by BMJ.)
Databáze:	MEDLINE
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