Delays in HIV and TB diagnosis and treatment initiation in co-infected patients in Colombia

Ríos-Hincapié, Cielo Y.; Rojas, Mónica Maldonado; López, M. L. Vidal; Porras, Alexandra; Luque, Ricardo; Pelissari, Daniele Maria; López, Lucelly; Rueda, Zulma Vanessa

doi:10.1177/0956462419881074

Cited by 3 publications

(3 citation statements)

References 24 publications

(48 reference statements)

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“…We also show that the risk of HIV/EBV-1/2 multiple infection was higher in patients with longer HIV-1 infection, which emphasizes our warning because coinfections are common in patients who start treatment late, have the highest associated risk rate, and are also correlated with advanced clinical disease stages 117 , 118 . For EBV, this becomes more specific because the prevalence of EBV-1 and of multiple infection predominate in the most immunosuppressed patients; however, it is not known which factors may be involved in this scenario 44 , 119 .…”

Section: Discussionsupporting

confidence: 56%

Epidemiological risk factors associated with primary infection by Epstein–Barr virus in HIV-1-positive subjects in the Brazilian Amazon region

Pereira

França

Costa

et al. 2021

Sci Rep

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To identify the prevalence and risk factors for primary Epstein–Barr virus (EBV) infection in human immunodeficiency virus (HIV)-1-positive adult treatment-naïve patients between January 2018 and December 2019 in a state of the Brazilian Amazon region. A total of 268 HIV-1 positive patients and 65 blood donors participated in the study. Epidemiological data were obtained from medical records and through a designed questionnaire. EBV infection was screened by the semiquantitative detection of anti-viral capsid antigen (VCA) EBV IgM and IgG, followed by molecular detection of the EBNA-3C gene. The plasma viral loads of HIV-1 and EBV were quantified using a commercial kit. The prevalence of primary coinfection was 7.12%. The associated risk factors were education level, family income, history of illicit drug use and sexually transmitted infections, homosexual contact and condom nonuse. Approximately 58.5% had late initiation of highly active antiretroviral therapy, which influenced the risk of HIV-EBV 1/2 multiple infection (odds ratio (OR): 4.76; 95% CI 1.51–15.04) and symptom development (p = 0.004). HIV viral load was associated with patient age (OR: 2.04; 95% CI 2.01–2.07; p = 0.026) and duration of illicit drug use (OR: 1.57; 95% CI 1.12–2.22; p = 0.0548). EBV viral load was associated with younger age (OR: 0.82; 95% CI 0.79–1.03; p = 0.0579). The replication of both viruses was associated with symptom development (HIV = OR: 2.06; 95% CI 1.22–3.50; p = 0.0073; EBV = OR: 8.81; 95% CI 1–10; p = 0.0447). The prevalence of HIV/EBV coinfection was lower than that observed in other studies, and social vulnerability and promiscuous sexual behavior were associated risk factors. A long time of HIV-1 infection, without therapy, influenced the risk of coinfection and disease progression. The viral loads of both viruses may be associated with some epidemiological aspects of the population.

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Section: Discussionsupporting

confidence: 56%

Epidemiological risk factors associated with primary infection by Epstein–Barr virus in HIV-1-positive subjects in the Brazilian Amazon region

Pereira

França

Costa

et al. 2021

Sci Rep

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“…In a South African cohort including only PLWH with pulmonary TB older age (> 40 years) and HIV-RNA viral load > 400 copies/ml were predictors for delayed diagnosis, while being on ART at time of diagnosis was associated with lower risk of delayed diagnosis [ 20 ]. A study including all drug-susceptible TB cases in PLWH from Colombia found age between 15–34, age ≥ 45 years, and receiving tuberculin skin tests as a part of the diagnostic work-up associated with delayed diagnosis [ 21 ]. In a Brazilian cohort of 242 PLWH with TB, factors associated with patient delay were the symptoms asthenia, chest pain, and the use of illicit drugs, including IDU [ 22 ].…”

Section: Discussionmentioning

confidence: 99%

Delayed diagnosis of tuberculosis in persons living with HIV in Eastern Europe: associated factors and effect on mortality—a multicentre prospective cohort study

Kraef

Bentzon

Panteleev³

et al. 2021

BMC Infect Dis

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Background Early diagnosis of tuberculosis (TB) is important to reduce transmission, morbidity and mortality in people living with HIV (PLWH). Methods PLWH with a diagnosis of TB were enrolled from HIV and TB clinics in Eastern Europe and followed until 24 months. Delayed diagnosis was defined as duration of TB symptoms (cough, weight-loss or fever) for ≥ 1 month before TB diagnosis. Risk factors for delayed TB diagnosis were assessed using multivariable logistic regression. The effect of delayed diagnosis on mortality was assessed using Kaplan–Meier estimates and Cox models. Findings 480/740 patients (64.9%; 95% CI 61.3–68.3%) experienced a delayed diagnosis. Age ≥ 50 years (vs. < 50 years, aOR = 2.51; 1.18–5.32; p = 0.016), injecting drug use (IDU) (vs. non-IDU aOR = 1.66; 1.21–2.29; p = 0.002), being ART naïve (aOR = 1.77; 1.24–2.54; p = 0.002), disseminated TB (vs. pulmonary TB, aOR = 1.56, 1.10–2.19, p = 0.012), and presenting with weight loss (vs. no weight loss, aOR = 1.63; 1.18–2.24; p = 0.003) were associated with delayed diagnosis. PLWH with a delayed diagnosis were at 36% increased risk of death (hazard ratio = 1.36; 1.04–1.77; p = 0.023, adjusted hazard ratio 1.27; 0.95–1.70; p = 0.103). Conclusion Nearly two thirds of PLWH with TB in Eastern Europe had a delayed TB diagnosis, in particular those of older age, people who inject drugs, ART naïve, with disseminated disease, and presenting with weight loss. Patients with delayed TB diagnosis were subsequently at higher risk of death in unadjusted analysis. There is a need for optimisation of the current TB diagnostic cascade and HIV care in PLWH in Eastern Europe.

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“…An estimated 38.0 million people were living with HIV/AIDS globally with the annual number of deaths standing at 970,000 in 2021, and 25% were co-infected with Mycobacterium tuberculosis ( M.tb ), the causative agent of TB [ 1 ]. Albeit that there are diagnostic tests currently available for HIV and TB, the diagnosis of these two diseases is still performed separately and this can delay treatment in co-infected individuals, particularly because active TB diagnosis can take a long time [ 2 , 3 ]. With HIV, there is a rapid test for the detection of p24, in addition to the PCR test.…”

Section: Introductionmentioning

confidence: 99%

Development of a Multiplex HIV/TB Diagnostic Assay Based on the Microarray Technology

Malatji,

Singh,

Thobakgale

et al. 2023

Biosensors

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Currently there are diagnostic tests available for human immunodeficiency virus (HIV) and tuberculosis (TB); however, they are still diagnosed separately, which can delay treatment in cases of co-infection. Here we report on a multiplex microarray technology for the detection of HIV and TB antibodies using p24 as well as TB CFP10, ESAT6 and pstS1 antigens on epoxy-silane slides. To test this technology for antigen–antibody interactions, immobilized antigens were exposed to human sera spiked with physiological concentrations of primary antibodies, followed by secondary antibodies conjugated to a fluorescent reporter. HIV and TB antibodies were captured with no cross-reactivity observed. The sensitivity of the slides was compared to that of high-binding plates. We found that the slides were more sensitive, with the detection limit being 0.000954 µg/mL compared to 4.637 µg/mL for the plates. Furthermore, stability studies revealed that the immobilized antigens could be stored dry for at least 90 days and remained stable across all pH and temperatures assessed, with pH 7.4 and 25 °C being optimal. The data collectively suggested that the HIV/TB multiplex detection technology we developed has the potential for use to diagnose HIV and TB co-infection, and thus can be developed further for the purpose.

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Delays in HIV and TB diagnosis and treatment initiation in co-infected patients in Colombia

Cited by 3 publications

References 24 publications

Epidemiological risk factors associated with primary infection by Epstein–Barr virus in HIV-1-positive subjects in the Brazilian Amazon region

Epidemiological risk factors associated with primary infection by Epstein–Barr virus in HIV-1-positive subjects in the Brazilian Amazon region

Delayed diagnosis of tuberculosis in persons living with HIV in Eastern Europe: associated factors and effect on mortality—a multicentre prospective cohort study

Development of a Multiplex HIV/TB Diagnostic Assay Based on the Microarray Technology

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