Risk of tuberculosis after initiation of antiretroviral therapy among persons with HIV in Europe

Isik S. Johansen; Ashley Roen; Christian Kraef; Raquel Martín-Iguacel; Johannes Nemeth; Lukas Fenner; Robert Zangerle; Josep M. Llibre; Robert F. Miller; Isabelle Suarez; Stephane de Wit; Ferdinand Wit; Christina Mussini; Annalisa Saracino; Diana Canetti; Alain Volny-Anne; Nadine Jaschinski; Bastian Neesgaard; Lene Ryom; Lars Peters; Harmony P. Garges; James F. Rooney; Daria Podlekareva; Amanda Mocroft; Ole Kirk

doi:10.1016/j.ijid.2024.107199

Risk of tuberculosis after initiation of antiretroviral therapy among persons with HIV in Europe

Isik S. Johansen^*, Ashley Roen, Christian Kraef, Raquel Martín-Iguacel, Johannes Nemeth, Lukas Fenner, Robert Zangerle, Josep M. Llibre, Robert F. Miller, Isabelle Suarez, Stephane de Wit, Ferdinand Wit, Christina Mussini, Annalisa Saracino, Diana Canetti, Alain Volny-Anne, Nadine Jaschinski, Bastian Neesgaard, Lene Ryom, Lars PetersHarmony P. Garges, James F. Rooney, Daria Podlekareva, Amanda Mocroft, Ole Kirk

^*Corresponding author af dette arbejde

Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › peer review

1 Citationer (Scopus)

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Abstract

Objectives
Tuberculosis (TB) risk after initiation of antiretroviral treatment (ART) is not well described in a European setting, with an average TB incidence of 25/10 5 in the background population.

Methods
We included all adult persons with HIV starting ART in the RESPOND cohort between 2012 and 2020. TB incidence rates (IR) were assessed for consecutive time intervals post-ART initiation. Risk factors for TB within 6 months from ART initiation were evaluated using Poisson regression models.

Results
Among 8441 persons with HIV, who started ART, 66 developed TB during 34,239 person-years of follow-up (PYFU), corresponding to 1.87/1000 PYFU (95% confidence interval [CI]: 1.47-2.37). TB IR was highest in the first 3 months after ART initiation (14.41/1000 PY (95%CI 10.08-20.61]) and declined at 3-6, 6-12, and >12 months post-ART initiation (5.89 [95%CI 3.35-10.37], 2.54 [95%CI 1.36-4.73] and 0.51 [95%CI 0.30-0.86]), respectively. Independent risk factors for TB within the first 6 months after ART initiation included follow-up in Northern or Eastern Europe region, African origin, baseline CD4 count <200 cells/mm 3 , HIV RNA >100,000 copies/mL, injecting drug use and heterosexual transmission.

Conclusions
TB IR was highest in the first 3 months post-ART initiation and was associated with baseline risk factors, highlighting the importance of thorough TB risk assessment at ART initiation.

Originalsprog	Engelsk
Artikelnummer	107199
Tidsskrift	International Journal of Infectious Diseases
Vol/bind	147
Antal sider	9
ISSN	1201-9712
DOI	https://doi.org/10.1016/j.ijid.2024.107199
Status	Udgivet - 2024

Bibliografisk note

Funding Information:
The International Cohort Consortium of Infectious Disease (RESPOND) is supported by The CHU St Pierre Brussels HIV Cohort, The Austrian HIV Cohort Study, The Australian HIV Observational Database, The AIDS Therapy Evaluation in the Netherlands National Observational HIV cohort, The EuroSIDA cohort, The Frankfurt HIV Cohort Study, The Georgian National AIDS Health Information System, The Nice HIV Cohort, The ICONA Foundation, The Modena HIV Cohort, The PISCIS Cohort Study, The Swiss HIV Cohort Study, The Swedish InfCare HIV Cohort, The Royal Free HIV Cohort Study, The San Raffaele Scientific Institute, The University Hospital Bonn HIV Cohort, The University of Cologne HIV Cohort, The Brighton HIV Cohort and The National Croatian HIV cohort. RESPOND is further financially supported by ViiV Healthcare, Merck Life Sciences, Gilead Sciences, the EuroSIDA Cohort and the AHOD cohort by grant No. U01-AI069907 from the U.S. National Institutes of Health, and GNT1050874 of the National Health and Medical Research Council, Australia. The study is approved by the Danish Data Protection Agency (j.nr.: RH-2018-15, 26/1/2018), currently under the EU's General Data Protection Regulation (EU) 2016/679.

Funding Information:
The International Cohort Consortium of Infectious Disease (RESPOND) is supported by The CHU St Pierre Brussels HIV Cohort, The Austrian HIV Cohort Study, The Australian HIV Observational Database, The AIDS Therapy Evaluation in the Netherlands National Observational HIV cohort, The EuroSIDA cohort, The Frankfurt HIV Cohort Study, The Georgian National AIDS Health Information System, The Nice HIV Cohort, The ICONA Foundation, The Modena HIV Cohort, The PISCIS Cohort Study, The Swiss HIV Cohort Study, The Swedish InfCare HIV Cohort, The Royal Free HIV Cohort Study, The San Raffaele Scientific Institute, The University Hospital Bonn HIV Cohort, The University of Cologne HIV Cohort, The Brighton HIV Cohort and The National Croatian HIV cohort. RESPOND is further financially supported by ViiV Healthcare, Merck Life Sciences, Gilead Sciences, the EuroSIDA Cohort and the AHOD cohort by grant No. U01-AI069907 from the U.S. National Institutes of Health, and GNT1050874 of the National Health and Medical Research Council, Australia.

Publisher Copyright:
© 2024 The Author(s)

Adgang til dokumentet

10.1016/j.ijid.2024.107199Licens: CC BY-NC-ND

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Citationsformater

Johansen, I. S., Roen, A., Kraef, C., Martín-Iguacel, R., Nemeth, J., Fenner, L., Zangerle, R., Llibre, J. M., Miller, R. F., Suarez, I., de Wit, S., Wit, F., Mussini, C., Saracino, A., Canetti, D., Volny-Anne, A., Jaschinski, N., Neesgaard, B., Ryom, L., ... Kirk, O. (2024). Risk of tuberculosis after initiation of antiretroviral therapy among persons with HIV in Europe. International Journal of Infectious Diseases, 147, Artikel 107199. https://doi.org/10.1016/j.ijid.2024.107199

Johansen, IS, Roen, A, Kraef, C, Martín-Iguacel, R, Nemeth, J, Fenner, L, Zangerle, R, Llibre, JM, Miller, RF, Suarez, I, de Wit, S, Wit, F, Mussini, C, Saracino, A, Canetti, D, Volny-Anne, A, Jaschinski, N, Neesgaard, B, Ryom, L, Peters, L, Garges, HP, Rooney, JF, Podlekareva, D, Mocroft, A & Kirk, O 2024, 'Risk of tuberculosis after initiation of antiretroviral therapy among persons with HIV in Europe', International Journal of Infectious Diseases, bind 147, 107199. https://doi.org/10.1016/j.ijid.2024.107199

@article{5418630e23a3456aa991c82a376eccc8,

title = "Risk of tuberculosis after initiation of antiretroviral therapy among persons with HIV in Europe",

abstract = "Objectives: Tuberculosis (TB) risk after initiation of antiretroviral treatment (ART) is not well described in a European setting, with an average TB incidence of 25/105 in the background population. Methods: We included all adult persons with HIV starting ART in the RESPOND cohort between 2012 and 2020. TB incidence rates (IR) were assessed for consecutive time intervals post-ART initiation. Risk factors for TB within 6 months from ART initiation were evaluated using Poisson regression models. Results: Among 8441 persons with HIV, who started ART, 66 developed TB during 34,239 person-years of follow-up (PYFU), corresponding to 1.87/1000 PYFU (95% confidence interval [CI]: 1.47-2.37). TB IR was highest in the first 3 months after ART initiation (14.41/1000 PY (95%CI 10.08-20.61]) and declined at 3-6, 6-12, and >12 months post-ART initiation (5.89 [95%CI 3.35-10.37], 2.54 [95%CI 1.36-4.73] and 0.51 [95%CI 0.30-0.86]), respectively. Independent risk factors for TB within the first 6 months after ART initiation included follow-up in Northern or Eastern Europe region, African origin, baseline CD4 count <200 cells/mm3, HIV RNA >100,000 copies/mL, injecting drug use and heterosexual transmission. Conclusions: TB IR was highest in the first 3 months post-ART initiation and was associated with baseline risk factors, highlighting the importance of thorough TB risk assessment at ART initiation.",

keywords = "AIDS, ART, incidence, TB/HIV",

author = "Johansen, {Isik S.} and Ashley Roen and Christian Kraef and Raquel Mart{\'i}n-Iguacel and Johannes Nemeth and Lukas Fenner and Robert Zangerle and Llibre, {Josep M.} and Miller, {Robert F.} and Isabelle Suarez and {de Wit}, Stephane and Ferdinand Wit and Christina Mussini and Annalisa Saracino and Diana Canetti and Alain Volny-Anne and Nadine Jaschinski and Bastian Neesgaard and Lene Ryom and Lars Peters and Garges, {Harmony P.} and Rooney, {James F.} and Daria Podlekareva and Amanda Mocroft and Ole Kirk",

note = "Publisher Copyright: {\textcopyright} 2024 The Author(s)",

year = "2024",

doi = "10.1016/j.ijid.2024.107199",

language = "English",

volume = "147",

journal = "International Journal of Infectious Diseases",

issn = "1201-9712",

publisher = "Elsevier",

}

TY - JOUR

T1 - Risk of tuberculosis after initiation of antiretroviral therapy among persons with HIV in Europe

AU - Johansen, Isik S.

AU - Roen, Ashley

AU - Kraef, Christian

AU - Martín-Iguacel, Raquel

AU - Nemeth, Johannes

AU - Fenner, Lukas

AU - Zangerle, Robert

AU - Llibre, Josep M.

AU - Miller, Robert F.

AU - Suarez, Isabelle

AU - de Wit, Stephane

AU - Wit, Ferdinand

AU - Mussini, Christina

AU - Saracino, Annalisa

AU - Canetti, Diana

AU - Volny-Anne, Alain

AU - Jaschinski, Nadine

AU - Neesgaard, Bastian

AU - Ryom, Lene

AU - Peters, Lars

AU - Garges, Harmony P.

AU - Rooney, James F.

AU - Podlekareva, Daria

AU - Mocroft, Amanda

AU - Kirk, Ole

PY - 2024

Y1 - 2024

N2 - Objectives: Tuberculosis (TB) risk after initiation of antiretroviral treatment (ART) is not well described in a European setting, with an average TB incidence of 25/105 in the background population. Methods: We included all adult persons with HIV starting ART in the RESPOND cohort between 2012 and 2020. TB incidence rates (IR) were assessed for consecutive time intervals post-ART initiation. Risk factors for TB within 6 months from ART initiation were evaluated using Poisson regression models. Results: Among 8441 persons with HIV, who started ART, 66 developed TB during 34,239 person-years of follow-up (PYFU), corresponding to 1.87/1000 PYFU (95% confidence interval [CI]: 1.47-2.37). TB IR was highest in the first 3 months after ART initiation (14.41/1000 PY (95%CI 10.08-20.61]) and declined at 3-6, 6-12, and >12 months post-ART initiation (5.89 [95%CI 3.35-10.37], 2.54 [95%CI 1.36-4.73] and 0.51 [95%CI 0.30-0.86]), respectively. Independent risk factors for TB within the first 6 months after ART initiation included follow-up in Northern or Eastern Europe region, African origin, baseline CD4 count <200 cells/mm3, HIV RNA >100,000 copies/mL, injecting drug use and heterosexual transmission. Conclusions: TB IR was highest in the first 3 months post-ART initiation and was associated with baseline risk factors, highlighting the importance of thorough TB risk assessment at ART initiation.

AB - Objectives: Tuberculosis (TB) risk after initiation of antiretroviral treatment (ART) is not well described in a European setting, with an average TB incidence of 25/105 in the background population. Methods: We included all adult persons with HIV starting ART in the RESPOND cohort between 2012 and 2020. TB incidence rates (IR) were assessed for consecutive time intervals post-ART initiation. Risk factors for TB within 6 months from ART initiation were evaluated using Poisson regression models. Results: Among 8441 persons with HIV, who started ART, 66 developed TB during 34,239 person-years of follow-up (PYFU), corresponding to 1.87/1000 PYFU (95% confidence interval [CI]: 1.47-2.37). TB IR was highest in the first 3 months after ART initiation (14.41/1000 PY (95%CI 10.08-20.61]) and declined at 3-6, 6-12, and >12 months post-ART initiation (5.89 [95%CI 3.35-10.37], 2.54 [95%CI 1.36-4.73] and 0.51 [95%CI 0.30-0.86]), respectively. Independent risk factors for TB within the first 6 months after ART initiation included follow-up in Northern or Eastern Europe region, African origin, baseline CD4 count <200 cells/mm3, HIV RNA >100,000 copies/mL, injecting drug use and heterosexual transmission. Conclusions: TB IR was highest in the first 3 months post-ART initiation and was associated with baseline risk factors, highlighting the importance of thorough TB risk assessment at ART initiation.

KW - AIDS

KW - ART

KW - incidence

KW - TB/HIV

U2 - 10.1016/j.ijid.2024.107199

DO - 10.1016/j.ijid.2024.107199

M3 - Journal article

C2 - 39142437

AN - SCOPUS:85203802135

SN - 1201-9712

VL - 147

JO - International Journal of Infectious Diseases

JF - International Journal of Infectious Diseases

M1 - 107199

ER -