Does antiretroviral treatment increase the infectiousness of smear-positive pulmonary tuberculosis?

Khan, P.Y., Crampin, A.C. , Mzembe, T., Koole, O., Fielding, K.L., Kranzer, K. and Glynn, J.R. (2017) Does antiretroviral treatment increase the infectiousness of smear-positive pulmonary tuberculosis? International Journal of Tuberculosis and Lung Disease, 21(11), pp. 1147-1154. (doi: 10.5588/ijtld.17.0162) (PMID:29037295) (PMCID:PMC5644739)

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Abstract

BACKGROUND: Understanding of the effects of human immunodeficiency virus (HIV) infection and antiretroviral treatment (ART) on Mycobacterium tuberculosis transmission dynamics remains limited. We undertook a cross-sectional study among household contacts of smear-positive pulmonary tuberculosis (TB) cases to assess the effect of established ART on the infectiousness of TB. METHOD: Prevalence of tuberculin skin test (TST) positivity was compared between contacts of index cases aged 2–10 years who were HIV-negative, HIV-positive but not on ART, on ART for <1 year and on ART for ≥1 year. Random-effects logistic regression was used to take into account clustering within households. RESULTS: Prevalence of M. tuberculosis infection in contacts of HIV-negative patients, HIV-positive patients on ART ≥1 year and HIV-positive patients not on ART/on ART <1 year index cases was respectively 44%, 21% and 22%. Compared to contacts of HIV-positive index cases not on ART or recently started on ART, the odds of TST positivity was similar in contacts of HIV-positive index cases on ART ≥1 year (adjusted OR [aOR] 1.0, 95%CI 0.3–3.7). The odds were 2.9 times higher in child contacts of HIV-negative index cases (aOR 2.9, 95%CI 1.0–8.2). CONCLUSIONS: We found no evidence that established ART increased the infectiousness of smear-positive, HIV-positive index cases.

Item Type:Articles
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:Crampin, Professor Mia
Authors: Khan, P.Y., Crampin, A.C., Mzembe, T., Koole, O., Fielding, K.L., Kranzer, K., 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
Copyright Holders:Copyright © 2017 Khan et al.
First Published:First published in International Journal of Tuberculosis and Lung Disease 21(11):1147-1154
Publisher Policy:Reproduced under a Creative Commons License

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