Incidence of tuberculosis in HIV-infected patients in Spain: The impact of treatment for LTBI

I. Martínez-Pino, M. A. Sambeat, J. R. Lacalle-Remigio, P. Domingo

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    SETTING: Twenty hospitals in Spain. OBJECTIVE: To describe the incidence of active tuberculosis (TB) and factors related to TB development after treatment for latent tuberculous infection (TLTBI) in human immunodeficiency virus-1 (HIV-1) infected patients in the highly active antiretroviral therapy era. DESIGN: In a multicentre cohort of HIV-1-infected patients, we calculated TB incidence by tuberculin skin test (TST) results and TLTBI, and factors associated with a positive TST and the development of TB after TLTBI. RESULTS: Of 7902 patients, 6.5% had a history of TB at enrolment: 168 patients developed TB during 10 889 person-years (py) of follow-up, corresponding to an incidence rate of 1.54 cases per 100 py (95%CI 1.33-1.80). TB incidence in TST-positive patients who did not receive TLTBI was three times higher (6 cases/100 py) than in those who did (1.75 cases/100 py). In patients who received TLTBI, risk of development of TB was higher among cases aged <35 years (HR 6.14, 95%CI 1.12-33.73) and in those with a nadir CD4+ cell count of <200 cells/μl (HR 5.64, 95%CI 1.34-23.70). CONCLUSIONS: TLTBI is effective in preventing the development of TB in HIV-infected patients, particularly in those who were TST-positive. © 2013 The Union.
    Original languageEnglish
    JournalInternational Journal of Tuberculosis and Lung Disease
    Issue number12
    Publication statusPublished - 1 Dec 2013


    • Latent tuberculous infection
    • Treatment of latent tuberculous infection
    • Tuberculin skin test


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