Title
Antiretroviral treatment-associated tuberculosis in a prospective cohort of HIV-infected patients starting ARTAntiretroviral treatment-associated tuberculosis in a prospective cohort of HIV-infected patients starting ART
Author
Faculty/Department
Faculty of Pharmaceutical, Biomedical and Veterinary Sciences. Pharmacy
Faculty of Medicine and Health Sciences
Research group
Laboratory for Microbiology, Parasitology and Hygiene (LMPH)
Epidemiology and social medicine (ESOC)
Publication type
article
Publication
Taylor,
Subject
Human medicine
Source (journal)
Clinical and developmental immunology. - -
Volume/pages
(2011), p. 758350,1-758350,9
ISSN
1740-2522
ISI
000286249900001
Carrier
E-only publicatie
Target language
English (eng)
Full text (Publishers DOI)
Affiliation
University of Antwerp
Abstract
Commencement of antiretroviral treatment (ART) in severely immunosuppressed HIV-infected persons is associated with unmasking of subclinical disease. The subset of patients that are diagnosed with tuberculosis (TB) disease while on ART have been classified as ART-associated TB. Few studies have reported the incidence of ART-associated TB and unmasking TB-IRIS according to the International Network for the Study of HIV-Associated IRIS (INSHI) consensus definition. To determine the incidence and predictors of ART-associated TB, we screened 219 patients commencing ART at the Infectious Diseases Clinic in Kampala, Uganda for TB by symptoms, sputum microscopy, and chest X-rays and followed them for one year. Fourteen (6.4%) patients were diagnosed with TB during followup. Eight (3.8%) patients had ART-associated TB (incidence rate of 4.3 per 100 person years); of these, three patients fulfilled INSHI criteria for unmasking TB-associated IRIS (incidence rate of 1.6 per 100 person years). A body mass index of less than 18.5 kg/m2 BMI (HR 5.85 95% CI 1.2427.46, 𝑃 = . 0 2 5 ) and a C-reactive protein greater than 5 mg/L (HR 8.23 95% CI 1.3638.33, 𝑃 = . 0 2 0 ) were risk factors for ART-associated TB at multivariate analysis. In conclusion, with systematic TB screening (including culture and chest X-ray), the incidence of ART-associated TB is relatively low in settings with high HIV and TB prevalence.
Full text (open access)
https://repository.uantwerpen.be/docman/irua/9cf0ee/047a951d.pdf
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