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Community study of the relative impact of HIV-1 and HIV-2 on intrathoracic tuberculosis

Seng, R; Gustafson, Per LU ; Gomes, VF; Vieira, CS; Rabna, P; Larsen, O; Larouze, B; Norberg, R; Lisse, IM and Samb, B (2002) In AIDS 16(7). p.1059-1066
Abstract
Background: HIV-1 infection is associated with an increased incidence of and mortality from tuberculosis. Few community studies have examined the effect of HIV-2 on tuberculosis. Methods: We investigated the association between HIV-1, HIV-2 and active tuberculosis in four districts (population 42 709) in Bissau, capital of Guinea-Bissau, with the highest known seroprevalence of HIV-2 infection in the world. From May 1996 to June 1998, tuberculosis surveillance and active case finding among contacts was conducted. Patients were HIV-tested, given specific tuberculosis treatment for 8 months and followed regarding mortality. Simultaneously, an HIV sero-survey was performed in a random sample of 1748 permanent residents. Results: During a... (More)
Background: HIV-1 infection is associated with an increased incidence of and mortality from tuberculosis. Few community studies have examined the effect of HIV-2 on tuberculosis. Methods: We investigated the association between HIV-1, HIV-2 and active tuberculosis in four districts (population 42 709) in Bissau, capital of Guinea-Bissau, with the highest known seroprevalence of HIV-2 infection in the world. From May 1996 to June 1998, tuberculosis surveillance and active case finding among contacts was conducted. Patients were HIV-tested, given specific tuberculosis treatment for 8 months and followed regarding mortality. Simultaneously, an HIV sero-survey was performed in a random sample of 1748 permanent residents. Results: During a 25-month period, 366 tuberculosis cases were identified. After excluding cases among visitors to the area, and adjusting for age, the incidence of tuberculosis was 18.3 times higher (95% CI 12.9-26.0) among HIV-1-positive individuals, 13.7 times higher (9.0-20.7) among dually infected (HIV-1 and HIV-2), and 3.0 times higher (2.1-4.3) among HIV-2-infected compared with HIV-negative individuals. HIV-1 and dually infected tuberculosis patients had a higher mortality rate than HIV-negative tuberculosis patients [mortality ratio (MR) 2.68; CI 1.11 -6.48 and 2.89; CI 1.13-7.39, respectively]. The survival of HIV-2-positive tuberculosis patients was similar to that of HIV-negative tuberculosis patients (MR 1.19; CI 0.46-3.06). Conclusion: The presence of HIV-2 infection increases the incidence of tuberculosis compared with that in non-HIV-infected individuals, but does not affect tuberculosis-related mortality in the short term. In contrast, the presence of HIV-1 infection, alone or with HIV-2, has a several-fold greater impact on both the incidence of and mortality from tuberculosis. (C) 2002 Lippincott Williams Wilkins. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
co-infection, HIV-1, HIV-2, tuberculosis, mortality, incidence, Africa, community
in
AIDS
volume
16
issue
7
pages
1059 - 1066
publisher
Lippincott Williams & Wilkins
external identifiers
  • wos:000175517900013
  • pmid:11953473
  • scopus:0037013098
ISSN
1473-5571
language
English
LU publication?
yes
id
b355bc7a-19bf-4389-a62d-e674690bd091 (old id 893414)
alternative location
http://www.aidsonline.com/pt/re/aids/fulltext.00002030-200205030-00013.htm
date added to LUP
2008-01-21 09:03:55
date last changed
2017-01-29 03:31:12
@article{b355bc7a-19bf-4389-a62d-e674690bd091,
  abstract     = {Background: HIV-1 infection is associated with an increased incidence of and mortality from tuberculosis. Few community studies have examined the effect of HIV-2 on tuberculosis. Methods: We investigated the association between HIV-1, HIV-2 and active tuberculosis in four districts (population 42 709) in Bissau, capital of Guinea-Bissau, with the highest known seroprevalence of HIV-2 infection in the world. From May 1996 to June 1998, tuberculosis surveillance and active case finding among contacts was conducted. Patients were HIV-tested, given specific tuberculosis treatment for 8 months and followed regarding mortality. Simultaneously, an HIV sero-survey was performed in a random sample of 1748 permanent residents. Results: During a 25-month period, 366 tuberculosis cases were identified. After excluding cases among visitors to the area, and adjusting for age, the incidence of tuberculosis was 18.3 times higher (95% CI 12.9-26.0) among HIV-1-positive individuals, 13.7 times higher (9.0-20.7) among dually infected (HIV-1 and HIV-2), and 3.0 times higher (2.1-4.3) among HIV-2-infected compared with HIV-negative individuals. HIV-1 and dually infected tuberculosis patients had a higher mortality rate than HIV-negative tuberculosis patients [mortality ratio (MR) 2.68; CI 1.11 -6.48 and 2.89; CI 1.13-7.39, respectively]. The survival of HIV-2-positive tuberculosis patients was similar to that of HIV-negative tuberculosis patients (MR 1.19; CI 0.46-3.06). Conclusion: The presence of HIV-2 infection increases the incidence of tuberculosis compared with that in non-HIV-infected individuals, but does not affect tuberculosis-related mortality in the short term. In contrast, the presence of HIV-1 infection, alone or with HIV-2, has a several-fold greater impact on both the incidence of and mortality from tuberculosis. (C) 2002 Lippincott Williams Wilkins.},
  author       = {Seng, R and Gustafson, Per and Gomes, VF and Vieira, CS and Rabna, P and Larsen, O and Larouze, B and Norberg, R and Lisse, IM and Samb, B},
  issn         = {1473-5571},
  keyword      = {co-infection,HIV-1,HIV-2,tuberculosis,mortality,incidence,Africa,community},
  language     = {eng},
  number       = {7},
  pages        = {1059--1066},
  publisher    = {Lippincott Williams & Wilkins},
  series       = {AIDS},
  title        = {Community study of the relative impact of HIV-1 and HIV-2 on intrathoracic tuberculosis},
  volume       = {16},
  year         = {2002},
}