@article{e6e9e2d8c21e497f9c352e0c674daa5a,
title = "Tuberculosis along the continuum of HIV care in a cohort of adolescents living with HIV in Ethiopia",
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. 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.",
keywords = "INH preventive therapy, Pre-ART, TB incidence",
author = "Degu Jerene and W. Abebe and K. Taye and Suarez, {P. G.} and Y. Feleke and I. Hallstr{\"o}m and Ruff, {A. J.}",
note = "Funding Information: The study was funded by a Collaborative Initiative for Paediatric HIV Education and Research (CIPHER) grant from the International AIDS Society (IAS), Geneva, Switzerland, supported by ViiV Healthcare, Brentford, UK. The views expressed in this publication do not necessarily reflect the official policies of IAS or ViiV Healthcare. This publication was made possible in part with help from the Johns Hopkins University Center for AIDS Research (Baltimore, MD, USA), a National Institutes of Health (NIH) funded programme (P30AI094189), which is supported by the following NIH co-funding and participating institutes and centres: National Institute of Allergy and Infectious Diseases, National Cancer Institute, National Institute of Child Health and Human Development, National Heart, Lung, and Blood Institute, National Institute on Drug Abuse, National Institute of Mental Health, National Institute on Aging, Fogarty International Center, National Institute of General Medical Sciences, National Institute of Diabetes and Digestive and Kidney Diseases and Office of AIDS Research. The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH. We thank the Ethiopian Medical Association, Addis Ababa, Ethiopia, for administrative support. Conflicts of interest: none declared. Publisher Copyright: {\textcopyright} 2017 The Union.",
year = "2017",
month = jan,
day = "1",
doi = "10.5588/ijtld.16.0105",
language = "English (US)",
volume = "21",
pages = "32--37 and i",
journal = "International Journal of Tuberculosis and Lung Disease",
issn = "1027-3719",
publisher = "International Union against Tubercul. and Lung Dis.",
number = "1",
}