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Tuberculosis along the continuum of HIV care in a cohort of adolescents living with HIV in Ethiopia

Jerene, Degu LU ; Abebe, W.; Taye, K.; Suarez, P. G.; Feleke, Y.; Hallström, I. LU and Ruff, A. J. (2017) In International Journal of Tuberculosis and Lung Disease 21(1). p.32-37
Abstract

SETTING: Eight health facilities in Ethiopia. OBJECTIVE: To determine tuberculosis (TB) incidence rates and associated factors among adolescents living with the human immunodeficiency virus (ALHIV). DESIGN: This was a retrospective cohort study. Adolescents enrolled in HIV care between January 2005 and 31 December 2013 constituted the study population. The main outcome variable was TB diagnosis during follow-up. Baseline World Health Organization (WHO) clinical stage, CD4 count, previous history of TB and use of isoniazid preventive therapy (IPT) were the main independent variables. We estimated TB incidence rates as incident cases per 100 person-years of observation (PYO). Cox regression analysis was used to control for confounders.... (More)

SETTING: Eight health facilities in Ethiopia. OBJECTIVE: To determine tuberculosis (TB) incidence rates and associated factors among adolescents living with the human immunodeficiency virus (ALHIV). DESIGN: This was a retrospective cohort study. Adolescents enrolled in HIV care between January 2005 and 31 December 2013 constituted the study population. The main outcome variable was TB diagnosis during follow-up. Baseline World Health Organization (WHO) clinical stage, CD4 count, previous history of TB and use of isoniazid preventive therapy (IPT) were the main independent variables. We estimated TB incidence rates as incident cases per 100 person-years of observation (PYO). Cox regression analysis was used to control for confounders. RESULTS: Of the 1221 adolescents screened, 1072 were studied; 60.1% were girls. TB incidence rate was 16.32 per 100 PYO during pre-antiretroviral therapy (pre-ART) follow-up but declined to 2.25 per 100 PYO after initiation of ART. Advanced WHO clinical stage (adjusted hazard ratio [aHR] 2.71, 95%CI 1.69-4.33) and CD4 count <350 cells/μl (aHR 2.28, 95%CI 1.10-4.81) predicted TB incidence in the pre-ART cohort. IPT use was associated with a significant reduction in TB incidence in the ART cohort, but not in the pre-ART group. CONCLUSION: Although TB was a significant problem in ALHIV, timely administration of ART and IPT had a significant protective effect.

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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
INH preventive therapy, Pre-ART, TB incidence
in
International Journal of Tuberculosis and Lung Disease
volume
21
issue
1
pages
32 - 37
publisher
International Union against Tuberculosis and Lung Disease
external identifiers
  • scopus:85007569868
  • wos:000397553600008
ISSN
1027-3719
DOI
10.5588/ijtld.16.0105
language
English
LU publication?
yes
id
584699ff-2483-4873-bff4-e93d224afe0c
date added to LUP
2017-01-16 09:15:47
date last changed
2018-01-07 11:45:13
@article{584699ff-2483-4873-bff4-e93d224afe0c,
  abstract     = {<p>SETTING: Eight health facilities in Ethiopia. OBJECTIVE: To determine tuberculosis (TB) incidence rates and associated factors among adolescents living with the human immunodeficiency virus (ALHIV). DESIGN: This was a retrospective cohort study. Adolescents enrolled in HIV care between January 2005 and 31 December 2013 constituted the study population. The main outcome variable was TB diagnosis during follow-up. Baseline World Health Organization (WHO) clinical stage, CD4 count, previous history of TB and use of isoniazid preventive therapy (IPT) were the main independent variables. We estimated TB incidence rates as incident cases per 100 person-years of observation (PYO). Cox regression analysis was used to control for confounders. RESULTS: Of the 1221 adolescents screened, 1072 were studied; 60.1% were girls. TB incidence rate was 16.32 per 100 PYO during pre-antiretroviral therapy (pre-ART) follow-up but declined to 2.25 per 100 PYO after initiation of ART. Advanced WHO clinical stage (adjusted hazard ratio [aHR] 2.71, 95%CI 1.69-4.33) and CD4 count &lt;350 cells/μl (aHR 2.28, 95%CI 1.10-4.81) predicted TB incidence in the pre-ART cohort. IPT use was associated with a significant reduction in TB incidence in the ART cohort, but not in the pre-ART group. CONCLUSION: Although TB was a significant problem in ALHIV, timely administration of ART and IPT had a significant protective effect.</p>},
  author       = {Jerene, Degu and Abebe, W. and Taye, K. and Suarez, P. G. and Feleke, Y. and Hallström, I. and Ruff, A. J.},
  issn         = {1027-3719},
  keyword      = {INH preventive therapy,Pre-ART,TB incidence},
  language     = {eng},
  month        = {01},
  number       = {1},
  pages        = {32--37},
  publisher    = {International Union against Tuberculosis and Lung Disease},
  series       = {International Journal of Tuberculosis and Lung Disease},
  title        = {Tuberculosis along the continuum of HIV care in a cohort of adolescents living with HIV in Ethiopia},
  url          = {http://dx.doi.org/10.5588/ijtld.16.0105},
  volume       = {21},
  year         = {2017},
}