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Tuberculosis risk varies with the duration of HIV infection: a prospective study of european drug users with known date of HIV seroconversion
(Les risques de tuberculose varient avec la durée d'infection au VIH : une étude prospective sur les usagers de drogue européens dont la date de séroconversion VIH est connue)
Auteur(s) :
VAN ASTEN, L. ;
LANGENDAM, M. ;
ZANGERLE, R. ;
HERNANDEZ-AGUADO, I. ;
BOUFASSA, F. ;
SCHIFFER, V. ;
BRETTLE, R. P. ;
ROY ROBERTSON, J. ;
FONTANET A. ;
COUTINHO, R. A. ;
PRINS, M.
Année :
2003
Page(s) :
1201-1208
Langue(s) :
Anglais
Refs biblio. :
34
Domaine :
Drogues illicites / Illicit drugs
Discipline :
MAL (Maladies infectieuses / Infectious diseases)
Thésaurus mots-clés
TUBERCULOSE
;
VIH
;
INCIDENCE
;
DUREE
;
USAGER
;
VOIE INTRAVEINEUSE
Thésaurus géographique
EUROPE
Note générale :
Aids, 2003, 17, (8), 1201-1208
Note de contenu :
tabl.
Résumé :
ENGLISH :
Background: It is not known whether the risk of active tuberculosis disease varies with the length of time that individuals are infected with HIV. Objective: To study how, independently of CD4 T cell count, the risk of tuberculosis varies with the duration of HIV infection. Methods: Using Poisson regression analysis, the incidence of and risk factors for tuberculosis were studied in 683 injecting drug users (IDU) with a documented date of HIV seroconversion followed in seven cohorts in six European countries until 1998. Results: Overall incidence was 11.5/t000 person-years. Adjusted for CD4 T cell count and geographic region, the risk ratio (RR) for tuberculosis (both pulmonary and extrapulmonary), compared with the first 3 years of HIV infection, was 2.8 for years 4 to 6 of HIV infection [95% confidence interval (CI), 1.3-6.3], 1.2 for year 7 to 9 (95% CI, 0.3-4.2) and 4.6 after 9 years (95% CI, 1.4-15.0). The adjusted RR for geographic region was l3.1 (95% CI, 4.3-40,0) for Amsterdam and 15.8 (95% CI, 4.8-52.0) for the Valencian region of Spain compared with all other sites combined. Conclusion: The risk of tuberculosis is increased relatively early in HIV infection (year 4 to 6) and also later (after year 9) with possibly a relatively silent period between. As expected, IDU in Southern Europe have a substantially higher risk of tuberculosis than IDU in Northern and Central Europe. Amsterdam forms an exception for Northern Europe, with very high incidence rates. (Review' s abstract)
Background: It is not known whether the risk of active tuberculosis disease varies with the length of time that individuals are infected with HIV. Objective: To study how, independently of CD4 T cell count, the risk of tuberculosis varies with the duration of HIV infection. Methods: Using Poisson regression analysis, the incidence of and risk factors for tuberculosis were studied in 683 injecting drug users (IDU) with a documented date of HIV seroconversion followed in seven cohorts in six European countries until 1998. Results: Overall incidence was 11.5/t000 person-years. Adjusted for CD4 T cell count and geographic region, the risk ratio (RR) for tuberculosis (both pulmonary and extrapulmonary), compared with the first 3 years of HIV infection, was 2.8 for years 4 to 6 of HIV infection [95% confidence interval (CI), 1.3-6.3], 1.2 for year 7 to 9 (95% CI, 0.3-4.2) and 4.6 after 9 years (95% CI, 1.4-15.0). The adjusted RR for geographic region was l3.1 (95% CI, 4.3-40,0) for Amsterdam and 15.8 (95% CI, 4.8-52.0) for the Valencian region of Spain compared with all other sites combined. Conclusion: The risk of tuberculosis is increased relatively early in HIV infection (year 4 to 6) and also later (after year 9) with possibly a relatively silent period between. As expected, IDU in Southern Europe have a substantially higher risk of tuberculosis than IDU in Northern and Central Europe. Amsterdam forms an exception for Northern Europe, with very high incidence rates. (Review' s abstract)
Affiliation :
Municipal Hlth Serv. Amsterdam, Cluster Infectious Diseases, Nieuwe Achtergracht 100, 1018 WT Amsterdam
Pays-Bas. Netherlands.
Pays-Bas. Netherlands.