International Journal of Infectious Diseases (Oct 2024)
Risk of tuberculosis after initiation of antiretroviral therapy among persons with HIV in Europe
- Isik S. Johansen,
- Ashley Roen,
- Christian Kraef,
- Raquel Martín-Iguacel,
- Johannes Nemeth,
- Lukas Fenner,
- Robert Zangerle,
- Josep M. Llibre,
- Robert F. Miller,
- Isabelle Suarez,
- Stephane de Wit,
- Ferdinand Wit,
- Christina Mussini,
- Annalisa Saracino,
- Diana Canetti,
- Alain Volny-Anne,
- Nadine Jaschinski,
- Bastian Neesgaard,
- Lene Ryom,
- Lars Peters,
- Harmony P. Garges,
- James F. Rooney,
- Daria Podlekareva,
- Amanda Mocroft,
- Ole Kirk
Affiliations
- Isik S. Johansen
- Department of Infectious Diseases, Odense University Hospital, University of Southern Denmark, Odense, Denmark; Research Unit of Infectious Diseases, Department of Clinical Research, University of Southern Denmark, Odense, Denmark; Corresponding author: Isik Somuncu Johansen, Department of Infectious Diseases, Odense University Hospital, J. B. Winsløws Vej 4, Indgang 18 Penthouse 2. sal, 5000 Odense, Denmark.
- Ashley Roen
- Centre for Clinical Research, Epidemiology, Modelling and Evaluation (CREME), Institute for Global Health, University College London, London, UK; CHIP, Centre of Excellence for Health, Immunity and Infections, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
- Christian Kraef
- CHIP, Centre of Excellence for Health, Immunity and Infections, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark; Department of Infectious Diseases, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
- Raquel Martín-Iguacel
- Department of Infectious Diseases, Odense University Hospital, University of Southern Denmark, Odense, Denmark; Research Unit of Infectious Diseases, Department of Clinical Research, University of Southern Denmark, Odense, Denmark
- Johannes Nemeth
- Swiss HIV Cohort Study (SHCS), University of Zurich, Zurich, Switzerland
- Lukas Fenner
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
- Robert Zangerle
- Austrian HIV Cohort Study (AHIVCOS), Medizinische Universität Innsbruck, Innsbruck, Austria
- Josep M. Llibre
- Infectious Diseases Division, University Hospital Germans Trias, Badalona, Spain; Fight Infections Foundation, Badalona, Spain
- Robert F. Miller
- The Royal Free HIV Cohort Study, Royal Free Hospital, University College London, London, UK
- Isabelle Suarez
- Department of Internal Medicine, Medical Faculty and University Hospital Cologne, University of Cologne, Cologne, Germany
- Stephane de Wit
- CHU Saint-Pierre, Centre de Recherche en Maladies Infectieuses a.s.b.l., Brussels, Belgium
- Ferdinand Wit
- AIDS Therapy Evaluation in the Netherlands (ATHENA) Cohort, HIV Monitoring Foundation, Amsterdam, the Netherlands
- Christina Mussini
- Modena HIV Cohort, Università degli Studi di Modena, Modena, Italy
- Annalisa Saracino
- Italian Cohort Naive Antiretrovirals (ICONA), ASST Santi Paolo e Carlo, Milano, Italy
- Diana Canetti
- San Raffaele Scientific Institute, Università Vita-Salute San Raffaele, Milano, Italy
- Alain Volny-Anne
- European AIDS Treatment Group (EATG), Brussels, Belgium
- Nadine Jaschinski
- CHIP, Centre of Excellence for Health, Immunity and Infections, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
- Bastian Neesgaard
- CHIP, Centre of Excellence for Health, Immunity and Infections, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
- Lene Ryom
- CHIP, Centre of Excellence for Health, Immunity and Infections, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark; Dept of Infectious Diseases, Hvidovre Hospital, University of Copenhagen, Denmark; Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
- Lars Peters
- CHIP, Centre of Excellence for Health, Immunity and Infections, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
- Harmony P. Garges
- ViiV Healthcare, RTP, NC, USA
- James F. Rooney
- Gilead Sciences, Foster City, CA, USA
- Daria Podlekareva
- CHIP, Centre of Excellence for Health, Immunity and Infections, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark; Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark; Department of Respiratory Medicine and Infectious Disease, Copenhagen University Hospital, Bispebjerg, Denmark; Gilead Sciences, Foster City, CA, USA
- Amanda Mocroft
- Centre for Clinical Research, Epidemiology, Modelling and Evaluation (CREME), Institute for Global Health, University College London, London, UK; CHIP, Centre of Excellence for Health, Immunity and Infections, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
- Ole Kirk
- Research Unit of Infectious Diseases, Department of Clinical Research, University of Southern Denmark, Odense, Denmark; CHIP, Centre of Excellence for Health, Immunity and Infections, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark; Department of Infectious Diseases, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark; Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
- Journal volume & issue
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Vol. 147
p. 107199
Abstract
Objectives: Tuberculosis (TB) risk after initiation of antiretroviral treatment (ART) is not well described in a European setting, with an average TB incidence of 25/105 in the background population. Methods: We included all adult persons with HIV starting ART in the RESPOND cohort between 2012 and 2020. TB incidence rates (IR) were assessed for consecutive time intervals post-ART initiation. Risk factors for TB within 6 months from ART initiation were evaluated using Poisson regression models. Results: Among 8441 persons with HIV, who started ART, 66 developed TB during 34,239 person-years of follow-up (PYFU), corresponding to 1.87/1000 PYFU (95% confidence interval [CI]: 1.47-2.37). TB IR was highest in the first 3 months after ART initiation (14.41/1000 PY (95%CI 10.08-20.61]) and declined at 3-6, 6-12, and >12 months post-ART initiation (5.89 [95%CI 3.35-10.37], 2.54 [95%CI 1.36-4.73] and 0.51 [95%CI 0.30-0.86]), respectively. Independent risk factors for TB within the first 6 months after ART initiation included follow-up in Northern or Eastern Europe region, African origin, baseline CD4 count 100,000 copies/mL, injecting drug use and heterosexual transmission. Conclusions: TB IR was highest in the first 3 months post-ART initiation and was associated with baseline risk factors, highlighting the importance of thorough TB risk assessment at ART initiation.
