Does Tuberculosis Increase HIV Load? (original) (raw)

Journal Article

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1

London School of Hygiene and Tropical Medicine

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London, United Kingdom

2

Aurum Health Research

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Orkney

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London School of Hygiene and Tropical Medicine

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London, United Kingdom

Correspondence: Dr. Alison Grant,

Clinical Research Unit, London School of Hygiene and Tropical Medicine

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Keppel Street, London WC1E 7HT, United Kingdom

(alison.grant@lshtm.ac.uk).

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London School of Hygiene and Tropical Medicine

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London, United Kingdom

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National Institute for Communicable Diseases

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Johannesburg, South Africa

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2

Aurum Health Research

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Orkney

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Aurum Health Research

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Orkney

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National Institute for Communicable Diseases

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Johannesburg, South Africa

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Johns Hopkins University

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Baltimore, Maryland

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London School of Hygiene and Tropical Medicine

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London, United Kingdom

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London School of Hygiene and Tropical Medicine

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London, United Kingdom

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Published:

01 November 2004

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John H. Day, Alison D. Grant, Katherine L. Fielding, Lynn Morris, Victoria Moloi, Salome Charalambous, Adrian J. Puren, Richard E. Chaisson, Kevin M. De Cock, Richard J. Hayes, Gavin J. Churchyard, Does Tuberculosis Increase HIV Load?, The Journal of Infectious Diseases, Volume 190, Issue 9, 1 November 2004, Pages 1677–1684, https://doi.org/10.1086/424851
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Abstract

Background. The effect that tuberculosis (TB) has on human immunodeficiency virus (HIV) disease progression is not clearly understood.

Methods. In an observational cohort study of HIV-infected adults in South Africa, baseline and final HIV load were compared between individuals who experienced an episode of TB (n = 30) during follow-up and control subjects (np56) matched by baseline CD4 cell count and follow-up time; linear regression modeling was used to control for confounding.

Results. Mean HIV load was higher in the TB group than in the non-TB control group for both baseline (4.73 vs. 4.24 log10 copies/mL; ) and final values (5.02 vs. 4.34 log10 Pp.003 copies/mL; P < .001). After adjustment for baseline HIV load and World Health Organization HIV stage, the difference in final HIV load was 0.24 log10 copies/mL (95% confidence interval,-0.01 to 0.50 log10 copies/mL; Pp.06).

Conclusions. Poor prognosis for HIV-infected individuals after TB may be due to preexisting high HIV load rather than to the TB event itself. An episode of TB was associated with a small adjusted increase in HIV load at the end of the study—an increase that would not be regarded as clinically significant in an individual but could have some effect on HIV disease progression or HIV transmission at the population level. Prevention of TB is important for the reduction of HIV-related morbidity and mortality; however, antiretroviral therapy is required to have a major effect on survival in individuals with HIV disease.

© 2004 by the Infectious Diseases Society of America

Topic:

• hiv
• cd4 count determination procedure
• follow-up
• tuberculosis
• hiv infections

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