Risk factors for tuberculosis after highly active antiretroviral therapy initiation in the United States and Canada

Implications for tuberculosis screening

Timothy R. Sterling, Bryan M Lau, Jinbing Zhang, Aimee Freeman, Ronald J. Bosch, John T. Brooks, Steven G. Deeks, Audrey French, Stephen J Gange, Kelly Gebo, M. John Gill, Michael A. Horberg, Lisa Paula Jacobson, Gregory D Kirk, Mari M. Kitahata, Marina B. Klein, Jeffrey N. Martin, Benigno Rodriguez, Michael J. Silverberg, James H. Willig & 8 others Joseph J. Eron, James J. Goedert, Robert S. Hogg, Amy C. Justice, Rosemary G. McKaig, Sonia Napravnik, Jennifer Thorne, Richard D Moore

Research output: Contribution to journalArticle

Abstract

Background. Screening for tuberculosis prior to highly active antiretroviral therapy (HAART) initiation is not routinely performed in low-incidence settings. Identifying factors associated with developing tuberculosis after HAART initiation could focus screening efforts. Methods. Sixteen cohorts in the United States and Canada contributed data on persons infected with human immunodeficiency virus (HIV) who initiated HAART December 1995-August 2009. Parametric survival models identified factors associated with tuberculosis occurrence. Results. Of 37 845 persons in the study, 145 were diagnosed with tuberculosis after HAART initiation. Tuberculosis risk was highest in the first 3 months of HAART (20 cases; 215 cases per 100 000 person-years; 95% confidence interval [CI]: 131-333 per 100 000 person-years). In a multivariate Weibull proportional hazards model, baseline CD4+ lymphocyte count 3 or increased HIV-1 RNA, persons of nonwhite race or Hispanic ethnicity, history of injection drug use, and possibly male sex.

Original languageEnglish (US)
Pages (from-to)893-901
Number of pages9
JournalJournal of Infectious Diseases
Volume204
Issue number6
DOIs
StatePublished - Sep 15 2011

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Highly Active Antiretroviral Therapy
Canada
Tuberculosis
CD4 Lymphocyte Count
Hispanic Americans
Proportional Hazards Models
HIV-1
HIV
RNA
Confidence Intervals
Injections
Survival
Incidence
Pharmaceutical Preparations

ASJC Scopus subject areas

  • Infectious Diseases
  • Immunology and Allergy

Cite this

Risk factors for tuberculosis after highly active antiretroviral therapy initiation in the United States and Canada : Implications for tuberculosis screening. / Sterling, Timothy R.; Lau, Bryan M; Zhang, Jinbing; Freeman, Aimee; Bosch, Ronald J.; Brooks, John T.; Deeks, Steven G.; French, Audrey; Gange, Stephen J; Gebo, Kelly; Gill, M. John; Horberg, Michael A.; Jacobson, Lisa Paula; Kirk, Gregory D; Kitahata, Mari M.; Klein, Marina B.; Martin, Jeffrey N.; Rodriguez, Benigno; Silverberg, Michael J.; Willig, James H.; Eron, Joseph J.; Goedert, James J.; Hogg, Robert S.; Justice, Amy C.; McKaig, Rosemary G.; Napravnik, Sonia; Thorne, Jennifer; Moore, Richard D.

In: Journal of Infectious Diseases, Vol. 204, No. 6, 15.09.2011, p. 893-901.

Research output: Contribution to journalArticle

Sterling, TR, Lau, BM, Zhang, J, Freeman, A, Bosch, RJ, Brooks, JT, Deeks, SG, French, A, Gange, SJ, Gebo, K, Gill, MJ, Horberg, MA, Jacobson, LP, Kirk, GD, Kitahata, MM, Klein, MB, Martin, JN, Rodriguez, B, Silverberg, MJ, Willig, JH, Eron, JJ, Goedert, JJ, Hogg, RS, Justice, AC, McKaig, RG, Napravnik, S, Thorne, J & Moore, RD 2011, 'Risk factors for tuberculosis after highly active antiretroviral therapy initiation in the United States and Canada: Implications for tuberculosis screening', Journal of Infectious Diseases, vol. 204, no. 6, pp. 893-901. https://doi.org/10.1093/infdis/jir421
Sterling, Timothy R. ; Lau, Bryan M ; Zhang, Jinbing ; Freeman, Aimee ; Bosch, Ronald J. ; Brooks, John T. ; Deeks, Steven G. ; French, Audrey ; Gange, Stephen J ; Gebo, Kelly ; Gill, M. John ; Horberg, Michael A. ; Jacobson, Lisa Paula ; Kirk, Gregory D ; Kitahata, Mari M. ; Klein, Marina B. ; Martin, Jeffrey N. ; Rodriguez, Benigno ; Silverberg, Michael J. ; Willig, James H. ; Eron, Joseph J. ; Goedert, James J. ; Hogg, Robert S. ; Justice, Amy C. ; McKaig, Rosemary G. ; Napravnik, Sonia ; Thorne, Jennifer ; Moore, Richard D. / Risk factors for tuberculosis after highly active antiretroviral therapy initiation in the United States and Canada : Implications for tuberculosis screening. In: Journal of Infectious Diseases. 2011 ; Vol. 204, No. 6. pp. 893-901.
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AU - Bosch, Ronald J.

AU - Brooks, John T.

AU - Deeks, Steven G.

AU - French, Audrey

AU - Gange, Stephen J

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AU - Rodriguez, Benigno

AU - Silverberg, Michael J.

AU - Willig, James H.

AU - Eron, Joseph J.

AU - Goedert, James J.

AU - Hogg, Robert S.

AU - Justice, Amy C.

AU - McKaig, Rosemary G.

AU - Napravnik, Sonia

AU - Thorne, Jennifer

AU - Moore, Richard D

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