TY - JOUR
T1 - Risk of tuberculosis after initiation of antiretroviral therapy among persons with HIV in Europe
AU - Johansen, Isik S
AU - Roen, Ashley
AU - Kraef, Christian
AU - Martín-Iguacel, Raquel
AU - Nemeth, Johannes
AU - Fenner, Lukas
AU - Zangerle, Robert
AU - Llibre, Josep M
AU - Miller, Robert F
AU - Suarez, Isabelle
AU - de Wit, Stephane
AU - Wit, Ferdinand
AU - Mussini, Christina
AU - Saracino, Annalisa
AU - Canetti, Diana
AU - Volny-Anne, Alain
AU - Jaschinski, Nadine
AU - Neesgaard, Bastian
AU - Ryom, Lene
AU - Peters, Lars
AU - Garges, Harmony P
AU - Rooney, James F
AU - Podlekareva, Daria
AU - Mocroft, Amanda
AU - Kirk, Ole
AU - RESPOND Study Group
N1 - Copyright © 2024. Published by Elsevier Ltd.
PY - 2024/8/12
Y1 - 2024/8/12
N2 - 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.
AB - 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.
U2 - 10.1016/j.ijid.2024.107199
DO - 10.1016/j.ijid.2024.107199
M3 - Journal article
C2 - 39142437
SN - 1201-9712
SP - 107199
JO - International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases
JF - International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases
ER -