Houben, R.M.G.J. et al. (2011) Human immunodeficiency virus associated tuberculosis more often due to recent infection than reactivation of latent infection. International Journal of Tuberculosis and Lung Disease, 15(1), pp. 24-31. (PMID:21276292)
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Publisher's URL: https://www.theunion.org/what-we-do/journals/ijtld
Abstract
Background: It is unclear whether human immunodeficiency virus (HIV) increases the risk of tuberculosis (TB) mainly through reactivation or following recent Mycobacterium tuberculosis (re)infection. Within a DNA fingerprint-defined cluster of TB cases, reactivation cases are assumed to be the source of infection for subsequent secondary cases. As HIV-positive TB cases are less likely to be source cases, equal or higher clustering in HIV-positives would suggest that HIV mainly increases the risk of TB following recent infection. Methods: A systematic review was conducted to identify all studies on TB clustering and HIV infection in HIV-endemic populations. Available individual patient data from eligible studies were pooled to analyse the association between clustering and HIV. Results: Of seven eligible studies, six contributed individual patient data on 2116 patients. Clustering was as, or more, likely in the HIV-positive population, both overall (summary OR 1.26, 95%CI 1.0–1.5), and within age groups (OR 1.50, 95%CI 0.9–2.3; OR 1.00, 95%CI 0.8–1.3 and OR 2.57, 95%CI 1.4–5.7) for ages 15–25, 26–50 and >50 years, respectively. Conclusions: Our results suggest that HIV infection mainly increases the risk of TB following recent M. tuberculosis transmission, and that TB control measures in HIV-endemic settings should therefore focus on controlling M. tuberculosis transmission rather than treating individuals with latent M. tuberculosis infection.
Item Type: | Articles |
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Additional Information: | Some of the studies that contributed data were funded by the Wellcome Trust. |
Status: | Published |
Refereed: | Yes |
Glasgow Author(s) Enlighten ID: | Crampin, Professor Mia |
Authors: | Houben, R.M.G.J., Crampin, A.C., Ndhlovu, R., Sonnenberg, P., Godfrey-Faussett, P., Haas, W.H., Engelmann, G., Lombard, C.J., Wilkinson, D., Bruchfeld, J., Lockman, S., Tappero, J., and Glynn, J.R. |
College/School: | College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > Public Health |
Journal Name: | International Journal of Tuberculosis and Lung Disease |
Publisher: | International Union Against Tuberculosis and Lung Disease |
ISSN: | 1027-3719 |
ISSN (Online): | 1815-7920 |
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