دورية أكاديمية
أعرض في EDS

Incidence of and risk factors for tuberculosis among people with HIV on antiretroviral therapy in the United Kingdom.

التفاصيل البيبلوغرافية
العنوان: Incidence of and risk factors for tuberculosis among people with HIV on antiretroviral therapy in the United Kingdom.
المؤلفون: van Halsema CL; Department of Infectious Diseases and Tropical Medicine, North Manchester General Hospital, Manchester.; Liverpool School of Tropical Medicine, Liverpool., Okhai H; Institute for Global Health., Hill T; Institute for Global Health., Sabin CA; Institute for Global Health.; National Institute for Health Research Health Protection Research Unit in Blood-Borne and Sexually Transmitted Infections, University College London, London, UK.
مؤلفون مشاركون: UK Collaborative HIV Cohort (UK CHIC) Study
المصدر: AIDS (London, England) [AIDS] 2020 Oct 01; Vol. 34 (12), pp. 1813-1821.
نوع المنشور: Journal Article; Observational Study; Research Support, Non-U.S. Gov't
اللغة: English
بيانات الدورية: Publisher: Lippincott Williams & Wilkins Country of Publication: England NLM ID: 8710219 Publication Model: Print Cited Medium: Internet ISSN: 1473-5571 (Electronic) Linking ISSN: 02699370 NLM ISO Abbreviation: AIDS Subsets: MEDLINE
أسماء مطبوعة: Publication: 1998- : London, England : Lippincott Williams & Wilkins
Original Publication: London : Gower Academic Journals, c1987-
مواضيع طبية MeSH: HIV Infections*/complications , HIV Infections*/drug therapy , Tuberculosis*/complications , Tuberculosis*/epidemiology, Adult ; CD4 Lymphocyte Count ; Female ; Humans ; Incidence ; Male ; Risk Factors ; United Kingdom/epidemiology ; Viral Load
مستخلص: Objective: The United Kingdom has a low tuberculosis incidence and earlier combination antiretroviral therapy (cART) is expected to have reduced incidence among people with HIV. Epidemiological patterns and risk factors for active tuberculosis were analysed over a 20-year period among people accessing HIV care at sites participating in the UK CHIC observational study.
Design: Cohort analysis.
Methods: Data were included for individuals over 15 years old attending for HIV care between 1996 and 2017 inclusive, with at least 3 months follow-up recorded. Incidence rates of new tuberculosis events were calculated and stratified by ethnicity (white/Black/other) as a proxy for tuberculosis exposure. Poisson regression models were used to determine the associations of calendar year, ethnicity and other potential risk factors after cART initiation.
Results: Fifty-eight thousand seven hundred and seventy-six participants (26.3% women; 54.5% white, 32.0% Black, 13.5% other/unknown ethnicity; median (interquartile range) age 34 (29-42) years) were followed for 546 617 person-years. Seven hundred and four were treated for active tuberculosis [rate 1.3; 95% confidence interval (CI) 1.2-1.4/1000 person-years). Tuberculosis incidence decreased from 1.3 (1.2-1.5) to 0.6 (0.4-0.9)/1000 person-years from pre-2004 to 2011-2017. The decline among people of Black ethnicity was less steep than among those of white/other ethnicities, with incidence remaining high among Black participants in the latest period [2.1 (1.4-3.1)/1000 person-years]. Two hundred and eighty-three participants [191 (67%) Black African] had tuberculosis with viral load less than 50 copies/ml.
Conclusion: Despite the known protective effect of cART against tuberculosis, a continuing disproportionately high incidence is seen among Black African people. Results support further interventions to prevent tuberculosis in this group.
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معلومات مُعتمدة: MR/M004236/1 United Kingdom MRC_ Medical Research Council; G0600337 United Kingdom MRC_ Medical Research Council; G0000199 United Kingdom MRC_ Medical Research Council; G0900274 United Kingdom MRC_ Medical Research Council; M004236 United Kingdom MRC_ Medical Research Council
تواريخ الأحداث: Date Created: 20200606 Date Completed: 20210218 Latest Revision: 20211208
رمز التحديث: 20221213
مُعرف محوري في PubMed: PMC8635262
DOI: 10.1097/QAD.0000000000002599
PMID: 32501837
قاعدة البيانات: MEDLINE
الوصف
تدمد:1473-5571
DOI:10.1097/QAD.0000000000002599