Long-term Protection From Tuberculosis Preventive Treatment Among People With HIV in a High-Burden Tuberculosis Setting: an Observational Cohort Study From India.

Details

• Alternative Title:
  Clinical Infectious Diseases : An Official Publication of the Infectious Diseases Society of America, 2025, v. 81, no. 5: Long-term Protection From Tuberculosis Preventive Treatment Among People With HIV in a High-Burden Tuberculosis Setting: an Observational Cohort Study From India.
• Journal Article:
  Clinical Infectious Diseases : An Official Publication of the Infectious Diseases Society of America
• Personal Author:
  Agarwal, Reshu ; Nyendak, Melissa ; Chava, Nalini ; Allam, Ramesh R. ; Moonan, Patrick K. ; Sriram, Chakravarthy S. ; Ganti, Ramesam ; Ragi, Praveen K. ; Polsani, Ajit R. ; Yeldandi, Vijay V. ; Ho, Christine ; Prasad, Rajendra P. ; Kurada, JayaKrishna ; Prasad, Kameswara ; Thogarucheeti, Manjula
• Description:
  Tuberculosis preventive treatment (TPT) is critical to the End TB strategy. There is limited evidence on its long-term protective effect among people with human immunodeficiency virus (HIV) receiving antiretroviral therapy (ART) in high-burden programmatic settings.
  
  This observational cohort study included people with HIV (PWH) who initiated a single TPT course from March 2017 to September 2018 at 14 ART centers in Andhra Pradesh, India (tuberculosis [TB] prevalence: 274/100 000). We followed PWH for 6 years and censored person-time at TB diagnosis, loss to follow-up, or death. We calculated TB incidence rates (IRs) and mortality rates (MRs) per 100 person-years (PY), stratified by TPT completion and effective ART (viral load <1000 copies/mL). Cox proportional hazards models estimated adjusted hazard ratios (aHRs) with 95% confidence limits (95% CL) for TB and mortality.
  
  We followed 4706 PWH for 23 414 PY. TB was diagnosed in 135 PWH (2.9%): 122 among 4454 PWH who completed TPT (IR, 0.55/100 PY [95% CL, .46-.66]) and 13 among 252 PWH who did not (IR, 1.06/100 PY [95% CL, .56-1.81]). There were 553 all-cause deaths (11.8%); the MR was 2.2/100 PY (95% CL, 2.0-2.4) among those who completed TPT compared to 13.5/100 PY (95% CL, 11.1-16.3) among those who did not. TPT, combined with effective ART, was associated with an 87% reduction in TB (aHR, 0.13 [95% CL, .05-.37]) and a 94% reduction in all-cause mortality (aHR, 0.06 [95% CL, .04-.10]).
  
  A single TPT course combined with effective ART conferred durable protection against TB and significantly reduced mortality among PWH in a high-TB-burden setting.
• Content Notes:
  Author manuscript
• Subjects:
  • Humans
  • HIV Infections
  • Male
  • Female
  • Tuberculosis
  • Adult
  • Cohort Studies
  • Antitubercular Agents
  • Middle Aged
  • Anti-HIV Agents
  More +
• Keywords:
  • HIV
  • tuberculosis preventive treatment
  • cohort study
  • antiretroviral treatment
  • viral suppression
• Source:
  Clinical Infectious Diseases : An Official Publication of the Infectious Diseases Society of America, 2025, v. 81, no. 5
• DOI:
  https://doi.org/10.1093/cid/ciaf322
• ISSN:
  1058-4838 ; 1537-6591
• Pubmed ID:
  40518945
• Pubmed Central ID:
  PMC13054132
• Document Type:
  Text
• Funding:
  U2G GH001346/GH/CGH CDC HHSUnited States/ ; GH002312/US Centers for Disease Control and Prevention/ ; National AIDS Control Programme/
• Genre:
  Journal Article
• Place as Subject:
  India
• Pages in Document:
  970-979 (19 pdf pages)
• Volume:
  81
• Issue:
  5
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha-512:0b643143483d6c4cc8bc23baa7e7c5d70546fa972d5bd4582493478c0cc8bf24dbeb2c9a4dcd6d8b7d5936efe639a366d73cb8c283460ee7e9298f1007f8af6e