Tuberculosis incidence in patients with human immunodeficiency virus, treated with isoniazid for latent tuberculosis infection

Authors

  • Claudia Teresa Vieira de Souza Fiocruz, Instituto Nacional de Infectologia Evandro Chagas (INI), Laboratório de Pesquisa em Epidemiologia e Determinação Social da Saúde, Rio de Janeiro, Rio de Janeiro, Brazil https://orcid.org/0000-0003-3208-722X
  • Maria de Lourdes Benamor Teixeira Fiocruz, Instituto Nacional de Infectologia Evandro Chagas (INI), Laboratório de Pesquisa em Epidemiologia e Determinação Social da Saúde, Rio de Janeiro, Rio de Janeiro, Brazil https://orcid.org/0000-0002-6896-0089
  • Maria Isabel Fragoso da Silveira Gouvêa Fiocruz, Instituto Nacional de Infectologia Evandro Chagas (INI), Laboratório de Pesquisa em Epidemiologia e Determinação Social da Saúde, Rio de Janeiro, Rio de Janeiro, Brazil https://orcid.org/0000-0002-1772-1942
  • Jacob Milnor Fiocruz, Instituto Oswaldo Cruz, Rio de Janeiro, Rio de Janeiro, Brazil https://orcid.org/0000-0003-3515-4360
  • Jose Berilo de Lima Filho Fiocruz, Instituto Nacional de Infectologia Evandro Chagas (INI), Serviço de Informação e Estatística, Rio de Janeiro, Rio de Janeiro, Brazil https://orcid.org/0000-0001-5338-9636
  • Marcel de Souza Borges Quintana Fiocruz, Instituto Nacional de Infectologia Evandro Chagas (INI), Plataforma de Pesquisa Clínica, Rio de Janeiro, Rio de Janeiro, Brazil https://orcid.org/0000-0001-5186-9791
  • Valéria Cavalcanti Rolla Fiocruz, Instituto Nacional de Infectologia Evandro Chagas (INI), Laboratório de Pesquisa Clínica em Micobacterioses, Rio de Janeiro, Rio de Janeiro, Brazil https://orcid.org/0000-0002-0841-1408

DOI:

https://doi.org/10.5216/rpt.v50i3.68574

Abstract

Tuberculosis is the leading cause of death amongst adults with human immunodeficiency virus (HIV) infection. The lifetime risk of tuberculosis disease for a person with latent infection is estimated at 5-10% with most cases occurring within five years of initial  infection. The World Health Organization recommends isoniazid preventive therapy (IPT) for latent tuberculosis treatment, amongst other strategies. The aim was to assess tuberculosis  incidence, survival (free of tuberculosis) and associated factors in HIV-positive patients. IPT was offered to participants with a positive (≥5mm) tuberculin skin test. Participants were followed from February 2003-December 2016. Kaplan-Meier was used for survival analysis. Variables with p-value ≤ 0.2 in the univariate analysis entered into the multivariate Cox-Model, keeping those with p-value ≤ 0.05. The 95% confidence interval of incidence of tuberculosis was estimated using Poisson distribution. One hundred nineteen patients completed the IPT and were followed for a median duration of 110.7 months (IQR 93.1-121.0). The probability of developing tuberculosis (10 years post-IPT) was 5.4%. Tuberculosis incidence was 0.58/100 patient/years (CI 95% 0.213-1.264). IPT over 6 months provided long-term protection against tuberculosis. AIDS-defining illness was the only statistically significant variable (HR=5.67) in the multivariate model.
KEY WORDS: Latent tuberculosis; HIV; isoniazid; survival analysis.

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Published

2021-09-14

How to Cite

VIEIRA DE SOUZA, C. T. .; BENAMOR TEIXEIRA, M. de L.; FRAGOSO DA SILVEIRA GOUVÊA, M. I. .; MILNOR, J. .; DE LIMA FILHO , J. B. .; DE SOUZA BORGES QUINTANA, M. .; CAVALCANTI ROLLA, V. . Tuberculosis incidence in patients with human immunodeficiency virus, treated with isoniazid for latent tuberculosis infection. Revista de Patologia Tropical / Journal of Tropical Pathology, Goiânia, v. 50, n. 3, p. 201–211, 2021. DOI: 10.5216/rpt.v50i3.68574. Disponível em: https://revistas.ufg.br/iptsp/article/view/68574. Acesso em: 16 aug. 2024.

Issue

Section

ORIGINAL ARTICLES