Abstract：
OBJECTIVE: 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.
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.
摘要：
目的：在欧洲环境中，开始抗逆转录病毒治疗（ART）后的结核病（TB）风险没有得到很好的描述，背景人群中结核病的平均发病率为25/105。
方法：我们在2012年至2020年期间将所有开始ART的HIV成人纳入RESPOND队列。在ART开始后的连续时间间隔内评估TB发病率(IR)。使用泊松回归模型评估ART开始后6个月内的结核病危险因素。
结果：在8441名HIV感染者中，谁开始了艺术，66人在34,239人年的随访中发展为结核病[PYFU]，对应于1.87/1000PYFU（95%置信区间[CI]：1.47-2.37）。开始ART后的前3个月TBIR最高（14.41/1000PY（95CI10.08-20.61]），在开始ART后3-6、6-12和>12个月时下降（5.89[95CI3.35-10.37]，2.54[95CI1.36-4.73]和0.51[95CI0.30-0.86])，分别。ART开始后的前6个月内结核病的独立危险因素包括在北欧或东欧地区的随访。非洲血统,基线CD4计数<200细胞/mm3，HIVRNA>100,000拷贝/mL，注射吸毒和异性传播。
结论：在ART开始后的前3个月中，TBIR最高，并且与基线危险因素相关，强调在ART开始时进行全面结核病风险评估的重要性。
方法：我们在2012年至2020年期间将所有开始ART的HIV成人纳入RESPOND队列。在ART开始后的连续时间间隔内评估TB发病率(IR)。使用泊松回归模型评估ART开始后6个月内的结核病危险因素。
结果：在8441名HIV感染者中，谁开始了艺术，66人在34,239人年的随访中发展为结核病[PYFU]，对应于1.87/1000PYFU（95%置信区间[CI]：1.47-2.37）。开始ART后的前3个月TBIR最高（14.41/1000PY（95CI10.08-20.61]），在开始ART后3-6、6-12和>12个月时下降（5.89[95CI3.35-10.37]，2.54[95CI1.36-4.73]和0.51[95CI0.30-0.86])，分别。ART开始后的前6个月内结核病的独立危险因素包括在北欧或东欧地区的随访。非洲血统,基线CD4计数<200细胞/mm3，HIVRNA>100,000拷贝/mL，注射吸毒和异性传播。
结论：在ART开始后的前3个月中，TBIR最高，并且与基线危险因素相关，强调在ART开始时进行全面结核病风险评估的重要性。
