Human immunodeficiency virus increases the risk of tuberculosis due to recent re-infection in individuals with latent infection

Houben, R.M.G.J., Glynn, J.R., Mallard, K., Sichali, L., Malema, S., Fine, P.E.M., French, N. and Crampin, A.C. (2010) Human immunodeficiency virus increases the risk of tuberculosis due to recent re-infection in individuals with latent infection. International Journal of Tuberculosis and Lung Disease, 14(7), pp. 909-915. (PMID:20550777) (PMCID:PMC3276831)

Abstract

Background: Human immunodeficiency virus associated tuberculosis (TB) disease can follow reactivation of latent Mycobacterium tuberculosis infection or recent (re-)infection with M. tuberculosis. If contemporary TB cases share identical M. tuberculosis strains (i.e., are ‘clustered’), the episode is likely to have followed recent (re-)infection, irrespective of evidence of previous latent infection. Methods: Individuals experiencing a first TB episode between 1996 and 2008 in Karonga District, Northern Malawi, were included if information on M. tuberculosis infection status (from tuberculin tests) before 1990 and a DNA fingerprint from the TB episode were available. We explored differences in proportion clustered by prior M. tuberculosis infection status and HIV status, adjusting for age, sex, bacille Calmette-Guérin scar status and time since tuberculin testing. Results: Of 79 HIV-negative TB cases, those with previous M. tuberculosis infection were much less likely to be clustered than cases without prior infection (29% vs. 77%, adjusted OR = 0.15, 95%CI 0.04–0.59). Among 119 HIV-positive TB cases, clustering was similar in both groups (88% vs. 84%, adjusted OR = 1.85, 95%CI 0.41–8.29). Discussion: HIV infection appears to increase the risk of TB following recent re-infection in patients with latent M. tuberculosis infection. Our results add to the mounting evidence that HIV-associated TB mainly follows recent M. tuberculosis infection.

• Item Type: Articles
• Additional Information: The authors thank the National Health and Science Research Committee and the Malawi National TB Programme for their collaboration over the past decades.
• Status: Published
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: Crampin, Professor Mia
• Authors: Houben, R.M.G.J., Glynn, J.R., Mallard, K., Sichali, L., Malema, S., Fine, P.E.M., French, N., and Crampin, A.C.
• 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