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Abstract
Incidence of tuberculosis in HIV-seroconverters from different transmission categories in Spain: 1982-2004
Muga R.1, Langohr K.1, del Romero J.2, García de Olalla P.3, Quintana M.4, Ruiz I.5, Ferreros I.6, Pérez-Hoyos S.6, Cisneros J.M.7, Sanvisens A.1, del Amo J.8, GEMES (Multicenter Study Group of Spanish Seroconverters)
Background: Spain has one of the highest rates of tuberculosis (TB) in western Europe;TB is the leading opportunistic infection since the beginning of HIV epidemic.
Objective: to analyze trends and determinants of incident tuberculosis (TB) among HIV-seroconverters before (<1997) and after (>1997) the introduction of highly active antiretroviral therapy (HAART).
Design: cohort study of 2.238 HIV-seroconverters from 9 cohorts included in the Multicenter Study Group of Spanish Seroconverters (GEMES).
Methods: Data from 1982 to 2004 were analyzed and censored by December 2004. The outcome of interest was the development of TB disease. Survival analyses using Kaplan-Meier methods and multivariate Cox regression allowing for late-entries were used. For the proportional hazard models, calendar period was modelled as a time-dependant covariate.
Results: 1.874 M, 364 W; 52% of patients were injecting drug users (IDU), 27% were persons with clotting disorders (PCD), and 21% acquired HIV infection by sexual transmission (ST). Median follow-up was 10 years (IQR 6.413.7 years). Overall, 173 (7.7%) patients developed TB over 23.698 p-y of follow-up (rate of 7.3x1.000 p-y) and Incident TB was higher in IDUs (12.3x1000 p-y) compared to ST (3.8x1000 p-y) and PCD (2.7x1000 p-y). TB was the first AIDS defining condition in 85% of cases. Median time observed in PCD since 1997.
Conclusions: important decreases in incident TB are observed in all transmission categories since the introduction of HAART in Spain. TB infection control, prophylactic therapy and uptake of HAART should be emphasized to further reduce the burden of TB among HIV+ IDUs.
4th IAS Conference on HIV Pathogenesis, Treatment and Prevention
Abstract no.
MOPEB019
Suggested Citation
"MugaR., et al.
Incidence of tuberculosis in HIV-seroconverters from different transmission categories in Spain: 1982-2004.
Poster exhibition:
4th IAS Conference on HIV Pathogenesis, Treatment and Prevention:
Abstract no.
MOPEB019"
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