Prevalence of IGRA-positivity and risk factors for tuberculosis among injecting drug users in Estonia and Latvia

Karnite, A; Talu, Ave; Abel-Ollo, Katri; Kirvelaite, Gunta; Kliiman, Kai; Loit, Helle‐Mai; Uusküla, Anneli

doi:10.1016/j.drugpo.2013.10.002

Cited by 5 publications

(3 citation statements)

References 7 publications

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“…31 IDU is a known risk factor for LTBI due to increased exposure in crowded environments and incarceration in correctional facilities. 26,32 IDU was associated with a fourfold risk of LTBI using QFT-G. Co-infection with HIV in IDUs was associated with a reduced rate of IGRA positivity using either QFT-G (26.0% vs. 14.3%, p Z 0.57) or QFT-GIT (31.7% vs. 7.1%, p Z 0.06). IGRAs are effective screening tools for IDU, and can avoid the confounding factors that limit the usefulness of TST, including HIV coinfection and difficulty in returning for the TST reading.…”

Section: Discussionmentioning

confidence: 89%

Prevalence of latent tuberculosis infection in persons with and without human immunodeficiency virus infection using two interferon-gamma release assays and tuberculin skin test in a low human immunodeficiency virus prevalence, intermediate tuberculosis-burden country

Lin

Lee

et al. 2016

Journal of Microbiology, Immunology and Infection

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Section: Discussionmentioning

confidence: 89%

Prevalence of latent tuberculosis infection in persons with and without human immunodeficiency virus infection using two interferon-gamma release assays and tuberculin skin test in a low human immunodeficiency virus prevalence, intermediate tuberculosis-burden country

Lin

Lee

et al. 2016

Journal of Microbiology, Immunology and Infection

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“…The correlation of IVDU and LTBI is known from an observational study from Estonia and Latvia and from an observational study in the United States (adjusted OR = 1.34) [21, 22]. Studies suggesting an association between IVDU and active tuberculosis were mostly small, confounded by HIV-infection or lacking control groups [23–28].…”

Section: Discussionmentioning

confidence: 99%

Risk for latent and active tuberculosis in Germany

et al. 2016

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PurposeFew individuals that are latently infected with M. tuberculosis latent tuberculosis infection(LTBI) progress to active disease. We investigated risk factors for LTBI and active pulmonary tuberculosis (PTB) in Germany.MethodsHealthy household contacts (HHCs), health care workers (HCWs) exposed to M. tuberculosis and PTB patients were recruited at 18 German centres. Interferon-γ release assay (IGRA) testing was performed. LTBI risk factors were evaluated by comparing IGRA-positive with IGRA-negative contacts. Risk factors for tuberculosis were evaluated by comparing PTB patients with HHCs.ResultsFrom 2008–2014, 603 HHCs, 295 HCWs and 856 PTBs were recruited. LTBI was found in 34.5% of HHCs and in 38.9% of HCWs. In HCWs, care for coughing patients (p = 0.02) and longstanding nursing occupation (p = 0.04) were associated with LTBI. In HHCs, predictors for LTBI were a diseased partner (odds ratio 4.39), sexual contact to a diseased partner and substance dependency (all p < 0.001). PTB was associated with male sex, low body weight (p < 0.0001), alcoholism (15.0 vs 5.9%; p < 0.0001), glucocorticoid therapy (7.2 vs 2.0%; p = 0.004) and diabetes (7.8 vs. 4.0%; p = 0.04). No contact developed active tuberculosis within 2 years follow-up.ConclusionsPositive IGRA responses are frequent among exposed HHCs and HCWs in Germany and are poor predictors for the development of active tuberculosis.Electronic supplementary materialThe online version of this article (doi:10.1007/s15010-016-0963-2) contains supplementary material, which is available to authorized users.

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“…In separate groups, PLHIV and HIV-uninfected individuals, we found that IDU is a significant risk factor for LTBI among PLHIV, and a history of contact with an active TB patient is a risk factor among HIV-uninfected individuals. Close contact with an active TB patient has been shown to be a risk factor in previous studies [ 43 , 44 , 45 , 46 , 47 ]. Imprisonment is commonly the primary risk factor for TB or an additional factor for TB evolution in the population with other risk factors, i.e., substance abuse and HIV infection.…”

Section: Discussionmentioning

confidence: 99%

Latent Tuberculosis Infection and Associated Risk Factors among People Living with HIV and HIV-Uninfected Individuals in Lithuania

Matulyte,

Kancauskiene,

Kausas

et al. 2023

Pathogens

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Background: People living with HIV (PLHIV) with latent tuberculosis infection (LTBI) are at increased risk of tuberculosis (TB) reactivation compared to the HIV-negative population. Lithuania belongs to the 18 high-priority TB countries in the European region. The aim of this study was to compare the prevalence of LTBI and LTBI-related risk factors between PLHIV and HIV-uninfected populations. Methods: A cross-sectional study was conducted in three Lithuanian Infectious Diseases centres from August 2018 to May 2022 using the interferon gamma release assay (IGRA) and tuberculin skin test (TST) in Vilnius, and IGRA only in Siauliai and Klaipeda. Cohen’s kappa was used to assess IGRA and TST agreement. A structured questionnaire was completed by the study participants. LTBI-related risk factors were identified using a multivariable logistic regression model. Results: In total, 391 PLHIV and 443 HIV-uninfected individuals enrolled, with a median age of 41 (IQR 36–48) and 43 (IQR 36–50), consisting of 69.8% and 65.5% male, respectively. The prevalence of LTBI defined by positive IGRA and/or TST among PLHIV was higher compared to that in the HIV-uninfected population (20.5% vs. 15.3%; OR 1.42; 95% CI 1.02–2.03; p = 0.04). The concordance between IGRA and TST was fair: kappa = 0.23 (95% CI 0.09–0.34). In multivariable analyses, association with injecting drug use (IDU) (ORa 2.25, 95% CI 1.27–3.99, p = 0.01) and imprisonment (ORa 1.99, 95% CI 1.13–3.52, p = 0.02) in all participants, IDU (ORa 2.37, 95% CI 1.09–5.15; p = 0.029) in PLHIV and a history of contact with an active TB patient (ORa 3.33, 95% CI 1.53–7.24; p = 0.002) in HIV-uninfected individuals were significant associations evidenced by LTBI. Conclusions: The prevalence of LTBI among PLHIV in Lithuania is higher compared to that in the HIV-uninfected population and the European average. The association with IDU in PLHIV emphasizes the need for integrated HIV, TB and substance abuse treatment to provide patient-centred care.

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Prevalence of IGRA-positivity and risk factors for tuberculosis among injecting drug users in Estonia and Latvia

Cited by 5 publications

References 7 publications

Prevalence of latent tuberculosis infection in persons with and without human immunodeficiency virus infection using two interferon-gamma release assays and tuberculin skin test in a low human immunodeficiency virus prevalence, intermediate tuberculosis-burden country

Prevalence of latent tuberculosis infection in persons with and without human immunodeficiency virus infection using two interferon-gamma release assays and tuberculin skin test in a low human immunodeficiency virus prevalence, intermediate tuberculosis-burden country

Risk for latent and active tuberculosis in Germany

Latent Tuberculosis Infection and Associated Risk Factors among People Living with HIV and HIV-Uninfected Individuals in Lithuania

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