dc.contributor.author | Njagi, Lilian N | |
dc.contributor.author | Nduba, Videlis | |
dc.contributor.author | Mureithi, Marianne W | |
dc.contributor.author | Mecha, Jared O | |
dc.date.accessioned | 2023-11-16T07:04:32Z | |
dc.date.available | 2023-11-16T07:04:32Z | |
dc.date.issued | 2023 | |
dc.identifier.citation | Njagi LN, Nduba V, Mureithi MW, Mecha JO. Prevalence and predictors of tuberculosis infection among people living with HIV in a high tuberculosis burden context. BMJ Open Respir Res. 2023 May;10(1):e001581. doi: 10.1136/bmjresp-2022-001581. PMID: 37197794; PMCID: PMC10193057. | en_US |
dc.identifier.uri | https://pubmed.ncbi.nlm.nih.gov/37197794/ | |
dc.identifier.uri | http://erepository.uonbi.ac.ke/handle/11295/163989 | |
dc.description.abstract | 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/m2; 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. | en_US |
dc.language.iso | en | en_US |
dc.publisher | University of Nairobi | en_US |
dc.rights | Attribution-NonCommercial-NoDerivs 3.0 United States | * |
dc.rights.uri | http://creativecommons.org/licenses/by-nc-nd/3.0/us/ | * |
dc.subject | Clinical Epidemiology; Immunodeficiency; Tuberculosis. | en_US |
dc.title | Prevalence and predictors of tuberculosis infection among people living with HIV in a high tuberculosis burden context | en_US |
dc.type | Article | en_US |