How Does Tuberculosis Relate to HIV Positive and HIV Negative Drug Users?

Overview

Journal J Epidemiol Community Health

Specialty Health Services

Date 2000 Feb 29

PMID 10692965

Citations 6

Authors

S T Keizer

M M Langendam

H van Deutekom

R A Coutinho

E J van Ameijden

Affiliations

Soon will be listed here.

Abstract

Objectives: (1) To compare the incidence of active tuberculosis in HIV positive and HIV negative drug users. (2) To describe the main characteristics of the tuberculosis cases.

Design: A prospective study was performed from 1986 to 1996 as part of an ongoing cohort study of HIV infection in Amsterdam drug users.

Methods: Data from the cohort study, including HIV serostatus and CD4-cell numbers, were completed with data from the tuberculosis registration of the tuberculosis department of the Amsterdam Municipal Health Service. Analyses were carried out with person time and survival methods.

Results: Of 872 participants, 24 persons developed culture confirmed tuberculosis during a total follow up period of 4000 person years (0.60 per 100 py, 95% CI: 0.40, 0.90). Nineteen cases were HIV positive (1.54 per 100 py, 95% CI: 0.86, 2.11) and five HIV negative (0.18 per 100 py, 95% CI: 0.08, 0.43). Multivariately HIV infection (relative risk: 12.9; 95% CI: 3.4, 48.8) and age above 33 years (RR: 6.8; 95% CI: 1.3, 35.0, as compared with age below 27) increased the risk for tuberculosis substantially. Additional findings were: (1) 13 of 22 pulmonary tuberculosis cases (59%) were detected by half yearly radiographic screening of the chest; (2) tuberculosis occurred relatively early in the course of HIV infection at a mean CD4 cell number of 390/microliter; (3) an estimated two thirds of the incidence of tuberculosis observed among HIV positive cases was caused by reactivation; (4) all but one patient completed the tuberculosis treatment.

Conclusion: HIV infection increases the risk for active tuberculosis in Amsterdam drug users 13-fold. The incidence of tuberculosis in HIV negative drug users is still six times higher than in the overall Amsterdam population. In the absence of contact tracing and screening with tuberculin skin tests, periodic chest radiographic screening contributes substantially to early casefinding of active tuberculosis in Amsterdam drug users.

Citing Articles

Incidence and factors associated with active tuberculosis among people living with HIV after long-term antiretroviral therapy in Thailand: a competing risk model.

Gatechompol S, Sophonphan J, Ubolyam S, Avihingsanon A, van Leth F, Cobelens F BMC Infect Dis. 2022; 22(1):346.

PMID: 35387594 PMC: 8988401. DOI: 10.1186/s12879-022-07332-3.

Biomarkers Can Identify Pulmonary Tuberculosis in HIV-infected Drug Users Months Prior to Clinical Diagnosis.

Sloot R, Schim van der Loeff M, van Zwet E, Haks M, Keizer S, Scholing M EBioMedicine. 2015; 2(2):172-9.

PMID: 26137541 PMC: 4484511. DOI: 10.1016/j.ebiom.2014.12.001.

Clinical manifestation and risk factors of tuberculosis infection in Malaysia: case study of a community clinic.

Shanmuganathan R, Subramaniam I Glob J Health Sci. 2015; 7(4):110-20.

PMID: 25946947 PMC: 4802090. DOI: 10.5539/gjhs.v7n4p110.

Global, regional, and national incidence and mortality for HIV, tuberculosis, and malaria during 1990-2013: a systematic analysis for the Global Burden of Disease Study 2013.

Murray C, Ortblad K, Guinovart C, Lim S, Wolock T, Roberts D Lancet. 2014; 384(9947):1005-70.

PMID: 25059949 PMC: 4202387. DOI: 10.1016/S0140-6736(14)60844-8.

Tuberculosis among drug users and homeless persons: impact of voluntary X-ray investigation on active case finding.

Goetsch U, Bellinger O, Buettel K, Gottschalk R Infection. 2012; 40(4):389-95.

PMID: 22237472 DOI: 10.1007/s15010-011-0238-x.

References

Reichman L, Felton C, EDSALL J . Drug dependence, a possible new risk factor for tuberculosis disease. Arch Intern Med. 1979; 139(3):337-9. View

Jansa J, Serrano J, Cayla J, Vidal R, Ocana I, Espanol T . Influence of the human immunodeficiency virus in the incidence of tuberculosis in a cohort of intravenous drug users: effectiveness of anti-tuberculosis chemoprophylaxis. Int J Tuberc Lung Dis. 1998; 2(2):140-6. View

van den Hoek J, Coutinho R, Van Haastrecht H, van Zadelhoff A, Goudsmit J . Prevalence and risk factors of HIV infections among drug users and drug-using prostitutes in Amsterdam. AIDS. 1988; 2(1):55-60. DOI: 10.1097/00002030-198802000-00010. View

Selwyn P, Hartel D, Lewis V, Schoenbaum E, Vermund S, Klein R . A prospective study of the risk of tuberculosis among intravenous drug users with human immunodeficiency virus infection. N Engl J Med. 1989; 320(9):545-50. DOI: 10.1056/NEJM198903023200901. View

Braun M, Badi N, Ryder R, Baende E, Mukadi Y, Nsuami M . A retrospective cohort study of the risk of tuberculosis among women of childbearing age with HIV infection in Zaire. Am Rev Respir Dis. 1991; 143(3):501-4. DOI: 10.1164/ajrccm/143.3.501. View

Barnes P, Bloch A, Davidson P, Snider Jr D . Tuberculosis in patients with human immunodeficiency virus infection. N Engl J Med. 1991; 324(23):1644-50. DOI: 10.1056/NEJM199106063242307. View

Hartgers C, van den Hoek A, Krijnen P, Coutinho R . HIV prevalence and risk behavior among injecting drug users who participate in "low-threshold" methadone programs in Amsterdam. Am J Public Health. 1992; 82(4):547-51. PMC: 1694108. DOI: 10.2105/ajph.82.4.547. View

Selwyn P, Sckell B, Alcabes P, Friedland G, Klein R, Schoenbaum E . High risk of active tuberculosis in HIV-infected drug users with cutaneous anergy. JAMA. 1992; 268(4):504-9. View

Allen S, Batungwanayo J, Kerlikowske K, Lifson A, Wolf W, Granich R . Two-year incidence of tuberculosis in cohorts of HIV-infected and uninfected urban Rwandan women. Am Rev Respir Dis. 1992; 146(6):1439-44. DOI: 10.1164/ajrccm/146.6.1439. View

10.

van Embden J, Cave M, Crawford J, Dale J, Eisenach K, Gicquel B . Strain identification of Mycobacterium tuberculosis by DNA fingerprinting: recommendations for a standardized methodology. J Clin Microbiol. 1993; 31(2):406-9. PMC: 262774. DOI: 10.1128/jcm.31.2.406-409.1993. View

11.

Moreno S, Bouza E, Parras F, Miralles P, Vicente T, Alberdi J . Risk for developing tuberculosis among anergic patients infected with HIV. Ann Intern Med. 1993; 119(3):194-8. DOI: 10.7326/0003-4819-119-3-199308010-00003. View

12.

Guelar A, Gatell J, Verdejo J, Podzamczer D, Lozano L, Aznar E . A prospective study of the risk of tuberculosis among HIV-infected patients. AIDS. 1993; 7(10):1345-9. DOI: 10.1097/00002030-199310000-00007. View

13.

Antonucci G, Girardi E, Raviglione M, Ippolito G . Risk factors for tuberculosis in HIV-infected persons. A prospective cohort study. The Gruppo Italiano di Studio Tubercolosi e AIDS (GISTA). JAMA. 1995; 274(2):143-8. DOI: 10.1001/jama.274.2.143. View

14.

Dupon M, Texier-Maugein J, Leroy V, Sentilhes A, Pellegrin J, Morlat P . Tuberculosis and HIV infection: a cohort study of incidence and susceptibility to antituberculous drugs, Bordeaux, 1985-1993. Groupe d'Epidémiologie Clinique du SIDA en Aquitaine. AIDS. 1995; 9(6):577-83. View

15.

Post F, Wood R, Pillay G . Pulmonary tuberculosis in HIV infection: radiographic appearance is related to CD4+ T-lymphocyte count. Tuber Lung Dis. 1995; 76(6):518-21. DOI: 10.1016/0962-8479(95)90527-8. View

16.

Cauthen G, DOOLEY S, Onorato I, Ihle W, Burr J, Bigler W . Transmission of Mycobacterium tuberculosis from tuberculosis patients with HIV infection or AIDS. Am J Epidemiol. 1996; 144(1):69-77. DOI: 10.1093/oxfordjournals.aje.a008856. View

17.

Ferreira M, Ferrazoli L, Palaci M, Salles P, Medeiros L, Novoa P . Tuberculosis and HIV infection among female inmates in São Paulo, Brazil: a prospective cohort study. J Acquir Immune Defic Syndr Hum Retrovirol. 1996; 13(2):177-83. DOI: 10.1097/00042560-199610010-00009. View

18.

Gordin F, Nelson E, Matts J, Cohn D, Ernst J, Benator D . The impact of human immunodeficiency virus infection on drug-resistant tuberculosis. Am J Respir Crit Care Med. 1996; 154(5):1478-83. DOI: 10.1164/ajrccm.154.5.8912768. View

19.

van Deutekom H, Gerritsen J, van Soolingen D, van Ameijden E, van Embden J, Coutinho R . A molecular epidemiological approach to studying the transmission of tuberculosis in Amsterdam. Clin Infect Dis. 1997; 25(5):1071-7. DOI: 10.1086/516072. View

20.

MANOS G, van Santen G, Leentvaar-Kuijpers A, Coutinho R . Tuberculin and 'multitest' skin-tests in drug abusers. Lancet. 1987; 2(8558):567-8. DOI: 10.1016/s0140-6736(87)92951-5. View