Does tuberculosis increase HIV load?

John H. Day, Alison D. Grant, Katherine L. Fielding, Lynn Morris, Victoria Moloi, Salome Charalambous, Adrian J. Puren, Richard E. Chaisson, Kevin M. De Cock, Richard J. Hayes, Gavin J. Churchyard

Research output: Contribution to journalArticle

Abstract

Background. The effect that tuberculosis (TB) has on human immunodeficiency virus (HIV) disease progression is not clearly understood. Methods. In an observational cohort study of HIV-infected adults in South Africa, baseline and final HIV load were compared between individuals who experienced an episode of TB (n = 30) during follow-up and control subjects (n = 56) matched by baseline CD4 cell count and follow-up time; linear regression modeling was used to control for confounding. Results. Mean HIV load was higher in the TB group than in the non-TB control group for both baseline (4.73 vs. 4.24 log 10 copies/mL; P = .003) and final values (5.02 vs. 4.34 log 10 copies/mL; P < .001). After adjustment for baseline HIV load and World Health Organization HIV stage, the difference in final HIV load was 0.24 log 10 copies/mL (95% confidence interval, -0.01 to 0.50 log 10 copies/mL; P = .06). Conclusions. Poor prognosis for HIV-infected individuals after TB may be due to preexisting high HIV load rather than to the TB event itself. An episode of TB was associated with a small adjusted increase in HIV load at the end of the study - an increase that would not be regarded as clinically significant in an individual but could have some effect on HIV disease progression or HIV transmission at the population level. Prevention of TB is important for the reduction of HIV-related morbidity and mortality; however, antiretroviral therapy is required to have a major effect on survival in individuals with HIV disease.

Original languageEnglish (US)
Pages (from-to)1677-1684
Number of pages8
JournalJournal of Infectious Diseases
Volume190
Issue number9
DOIs
StatePublished - Nov 1 2004
Externally publishedYes

ASJC Scopus subject areas

  • Immunology and Allergy
  • Infectious Diseases

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    Day, J. H., Grant, A. D., Fielding, K. L., Morris, L., Moloi, V., Charalambous, S., Puren, A. J., Chaisson, R. E., De Cock, K. M., Hayes, R. J., & Churchyard, G. J. (2004). Does tuberculosis increase HIV load? Journal of Infectious Diseases, 190(9), 1677-1684. https://doi.org/10.1086/424851