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

Martínez-Pino, Isabel; Sambeat, María A.; Lacalle-Remigio, Juan R.; Domingo, P

doi:10.5588/ijtld.13.0070

Cited by 15 publications

(26 citation statements)

References 23 publications

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“…Similar positive effects have been shown in HIV‐infected persons . Several other studies have also shown that treating latent tuberculosis is effective …”

Section: Premise 1: Tuberculosis Is a Problem And The Progress Towardsupporting

confidence: 74%

To eliminate tuberculosis, we must universally encourage treatment of its latent form

Schraufnagel

2015

Respirology

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“…Similar positive effects have been shown in HIV‐infected persons . Several other studies have also shown that treating latent tuberculosis is effective …”

Section: Premise 1: Tuberculosis Is a Problem And The Progress Towardsupporting

confidence: 74%

To eliminate tuberculosis, we must universally encourage treatment of its latent form

Schraufnagel

2015

Respirology

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“…In 2014, 142 197 newly diagnosed HIV infections were reported in the WHO European region [4], and 21 000 were provided with TB preventive therapy [16]. In a prospective cohort study in Spain, one-third of the HIV-positive cases without a history of TB were screened for latent TB infection, and of the cases with a positive screening result, approximately half received treatment for latent TB infection [34]. A cohort study in Switzerland showed that 69% of the patients without a history of TB were screened for latent TB infection, and 37% of those who tested positive received a full course of preventive treatment [35].…”

Section: Discussionmentioning

confidence: 99%

Tuberculosis and HIV coinfection in Europe

Werf

Ködmön

Zucs

et al. 2016

Aids

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Objective:To better understand the epidemiology of tuberculosis (TB)/HIV coinfection in the European Union (EU) and European Economic Area (EEA) for planning of prevention and control measures.Design:Analysis of surveillance data.Methods:We performed an analysis of the 2014 TB and AIDS data to assess the burden of TB/HIV coinfection and we applied multivariable logistic regression to evaluate predictors for coinfection.Results:Twenty-one of 31 EU/EEA countries reported HIV testing results for 64.6% of the 32 892 notified TB cases. Of those, 1051 (4.9%) were reported as HIV-positive. Males [adjusted odds ratio (aOR) 1.25; 95% confidence interval (CI) 1.07–1.46] and those in age group 25–44 years were more frequently coinfected. TB cases originating from the WHO African region had the highest proportion of coinfection (aOR 3.28 versus origin in EU/EEA; 95% CI 2.35–4.57). TB treatment was completed successfully by 57.9% of HIV-positive TB cases and 83.5% of HIV-negative cases. In 2014, 3863 cases of AIDS were reported by 29 EU/EEA countries; 691 (17.9%) of these cases presented with TB as an AIDS-defining illness. Persons who had acquired HIV through injecting drug use had higher odds of TB as an AIDS-defining illness (aOR 1.78 versus heterosexual route of transmission; 95% CI 1.37–2.32).Conclusion:TB/HIV coinfection is a substantial problem in the EU/EEA. The occurrence of TB in HIV-positive cases and the low TB treatment success rate suggest that international guidelines for prevention and treatment of TB in HIV-infected adults need to be better implemented.

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“…In studies from the high burden setting of the South African mines, the risk of TB infection has been shown to double within the first year, with Mtb strains significantly more likely to be unique within 2 years of HIV-seroconversion than later on in the disease, suggesting that TB may more likely be precipitated by reactivation early in the course of HIV and that recent reinfection with subsequent rapid progression occurs in more advanced immunosuppression [73]. Studies from low prevalence settings (Spain and Switzerland) suggest that the rate of TB in HIV-infected persons who are TST positive but untreated reduces over time, with most of the excess cases of TB compared with TST negative occurring within the first 2 years of follow-up; in total, only 10–12% of this very high-risk group developed TB over a follow-up period of up to 5 years [74,75]. …”

Section: The Natural History Of Tuberculosismentioning

confidence: 99%

The ongoing challenge of latent tuberculosis

Esmail

Barry²,

Young

et al. 2014

Phil. Trans. R. Soc. B

276

236

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The global health community has set itself the task of eliminating tuberculosis (TB) as a public health problem by 2050. Although progress has been made in global TB control, the current decline in incidence of 2% yr−1 is far from the rate needed to achieve this. If we are to succeed in this endeavour, new strategies to reduce the reservoir of latently infected persons (from which new cases arise) would be advantageous. However, ascertainment of the extent and risk posed by this group is poor. The current diagnostics tests (tuberculin skin test and interferon-gamma release assays) poorly predict who will develop active disease and the therapeutic options available are not optimal for the scale of the intervention that may be required. In this article, we outline a basis for our current understanding of latent TB and highlight areas where innovation leading to development of novel diagnostic tests, drug regimens and vaccines may assist progress. We argue that the pool of individuals at high risk of progression may be significantly smaller than the 2.33 billion thought to be immune sensitized by Mycobacterium tuberculosis and that identifying and targeting this group will be an important strategy in the road to elimination.

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

Abstract: TLTBI is effective in preventing the development of TB in HIV-infected patients, particularly in those who were TST-positive.

Cited by 15 publications

References 23 publications

To eliminate tuberculosis, we must universally encourage treatment of its latent form

To eliminate tuberculosis, we must universally encourage treatment of its latent form

Tuberculosis and HIV coinfection in Europe

The ongoing challenge of latent tuberculosis

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