3rd International AIDS Society Conference on HIV Pathogenesis and Treatment Rio de Janeiro - July 24 - 27, 2005

DEVELOPMENT OF TUBERCULOSIS IN HIV INFECTED PATIENTS TREATED WITH HIGHLY ACTIVE ANTIRETROVIRAL THERAPY (HAART)

IAS Conf HIV Pathog Treat 2005 Jul 24-27;3rd: Abstract No. TuPe7.1C15

Martín-Echevarría E., Casado J.L., Navas E., Dronda F., Antela A., Pérez-Elías M.J., Moreno A., Moreno S.
Department of Infectious Diseases. Hospital Ramón y Cajal., Madrid, Spain

INTRODUCTION: To evaluate the incidence of tuberculosis among HIV-infected individuals treated with HAART, and to identify factors associated with a higher risk of developing the disease.

METHODS: Observational, cohort study in a single institution. Patients were included in the analysis if they had received HAART (a combination of at least 3 antiretroviral drugs) at any time in the course of HIV infection. TB was diagnosed only if microbiologically proven. Univariate and multivariate analyses were performed to identify risk factors associated with the development of TB.

RESULTS: A total of 1,824 patients were included in the study. Median follow-up was 473 days. Most patients (59%) had acquired HIV-infection through intravenous drug uses, and 25% of the patients had been previously diagnosed of AIDS. A positive tuberculin skin test (TST) was observed in 339 patients (19%), and previous TB had been diagnosed in 254 (13%) before the initiation of HAART. Forty five cases of tuberculosis were observed with an overall incidence rate of 1.9 per 100 person-years of observation. By logistic regression analysis, a positive TST [RR (95%CI), 4.2 (1.9-9.4)], and baseline CD4 count [RR 1.003 (1.0008-1.006)] were independently associated with the risk of developing TB. The incidence of TB was 4.26 and 1.02 cases per 100 person-years among patients with positive and negative TST, respectively (p<0.001). Mean CD4 count/mm³ were 165 and 258 for patients who developed and did not develop TB, respectively (p<0.001).

CONCLUSIONS: The incidence of TB remains relatively high in patients treated with HAART, although it is lower than reported in the pre-HAART era. The higher risk observed in persons with a positive tuberculin skin test reinforces the recommendations of TST testing all HIV infected individuals, and of administering treatment of latent TB infection to all patients with a positive test regardless the administration of HAART.

Download PDF of this abstract.

050724
Clinical | TuPe7.1C15 | Santiago Moreno
Tuberculosis

Copyright © 2005 - International AIDS Society (IAS). All information and content relating to the abstracts from the 3rd International AIDS Society Conference on HIV Pathogenesis and Treatment, such as text, graphics, logos, button icons, images, audio clips, and software is protected by copyright. Permission is hereby granted for the non-commercial use or reproduction of the information on this web site, provided that the use of such information is accompanied by an acknowledgement that IAS is the source of the information and the name of the author of the article.

AEGiS is made possible through unrestricted funding from Boehringer Ingelheim, Bridgestone/Firestone Charitable Trust, Bristol-Myers Squibb Company, Elton John AIDS Foundation, the National Library of Medicine, and donations from users like you. Always watch for outdated information. This article first appeared in 2005. This material is designed to support, not replace, the relationship that exists between you and your doctor.

AEGiS presents published material, reprinted with permission and neither endorses nor opposes any material. All information contained on this website, including information relating to health conditions, products, and treatments, is for informational purposes only. It is often presented in summary or aggregate form. It is not meant to be a substitute for the advice provided by your own physician or other medical professionals. Always discuss treatment options with a doctor who specializes in treating HIV.

Copyright ©1980, 2005. AEGiS. All materials appearing on AEGiS are protected by copyright as a collective work or compilation under U.S. copyright and other laws and are the property of AEGiS, or the party credited as the provider of the content. Permission is hereby granted for the non-commercial use or reproduction of the information herein, provided that the use of such information is accompanied by an acknowledgement that IAS is the source of the information and the name of the author of the article.