Tuberculin skin test positivity among HIV-infected alcohol drinkers on antiretrovirals in south-western Uganda.
<h4>Background</h4>Tuberculosis (TB) is the leading cause of death among people living with HIV (PLWH), and current evidence suggests that heavy alcohol users have an increased risk of developing TB disease compared to non-drinkers. Not known is whether the increased risk for TB disease...
| Main Authors: | , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Public Library of Science (PLoS)
2020-01-01
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| Series: | PLoS ONE |
| Online Access: | https://doi.org/10.1371/journal.pone.0235261 |
| _version_ | 1811296591051489280 |
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| author | Winnie R Muyindike Robin Fatch Debbie M Cheng Nneka I Emenyonu Christine Ngabirano Julian Adong Benjamin P Linas Karen R Jacobson Judith A Hahn |
| author_facet | Winnie R Muyindike Robin Fatch Debbie M Cheng Nneka I Emenyonu Christine Ngabirano Julian Adong Benjamin P Linas Karen R Jacobson Judith A Hahn |
| author_sort | Winnie R Muyindike |
| collection | DOAJ |
| description | <h4>Background</h4>Tuberculosis (TB) is the leading cause of death among people living with HIV (PLWH), and current evidence suggests that heavy alcohol users have an increased risk of developing TB disease compared to non-drinkers. Not known is whether the increased risk for TB disease among alcohol users may reflect higher rates of latent TB infection (LTBI) among this population. We assessed the latent TB infection prevalence based on tuberculin skin testing (TST) and examined association with current alcohol use among HIV-infected persons on antiretroviral therapy (ART) in south-western Uganda.<h4>Methods</h4>We included PLWH at the Mbarara Regional Hospital HIV clinic, who were either current alcohol consumers (prior 3 months) or past year abstainers (2:1 enrolment ratio). Participants were recruited for a study of isoniazid preventive therapy for LTBI. TST was performed using 5 tuberculin units of purified protein derivative. The primary outcome was a positive TST reading (≥5mm induration), reflecting LTBI. We used logistic regression analyses to assess the cross-sectional association between self-reported current alcohol use and a positive TST.<h4>Results</h4>Of the 295 of 312 (95%) who returned for TST reading, 63% were females and 63% were current alcohol drinkers. The TST positive prevalence was 27.5% (95% confidence interval [CI]: 22.6% - 32.9%). The odds of a positive TST for current alcohol users compared to abstainers was 0.76 (95% CI: 0.41, 1.41), controlling for gender, age, body mass index, history of smoking, and prior unhealthy alcohol use.<h4>Conclusions</h4>The prevalence of LTBI among PLWH on ART in south-western Uganda was moderate and LTBI poses a risk for future infectious TB. Although alcohol use is common, we did not detect an association between current drinking or prior unhealthy alcohol use and LTBI. Further studies to evaluate the association between LTBI and different levels of current drinking (heavy versus not) are needed. |
| first_indexed | 2024-04-13T05:50:43Z |
| format | Article |
| id | doaj.art-c72802fe8c45449d9d434d0c3cbb34ab |
| institution | Directory Open Access Journal |
| issn | 1932-6203 |
| language | English |
| last_indexed | 2024-04-13T05:50:43Z |
| publishDate | 2020-01-01 |
| publisher | Public Library of Science (PLoS) |
| record_format | Article |
| series | PLoS ONE |
| spelling | doaj.art-c72802fe8c45449d9d434d0c3cbb34ab2022-12-22T02:59:47ZengPublic Library of Science (PLoS)PLoS ONE1932-62032020-01-01157e023526110.1371/journal.pone.0235261Tuberculin skin test positivity among HIV-infected alcohol drinkers on antiretrovirals in south-western Uganda.Winnie R MuyindikeRobin FatchDebbie M ChengNneka I EmenyonuChristine NgabiranoJulian AdongBenjamin P LinasKaren R JacobsonJudith A Hahn<h4>Background</h4>Tuberculosis (TB) is the leading cause of death among people living with HIV (PLWH), and current evidence suggests that heavy alcohol users have an increased risk of developing TB disease compared to non-drinkers. Not known is whether the increased risk for TB disease among alcohol users may reflect higher rates of latent TB infection (LTBI) among this population. We assessed the latent TB infection prevalence based on tuberculin skin testing (TST) and examined association with current alcohol use among HIV-infected persons on antiretroviral therapy (ART) in south-western Uganda.<h4>Methods</h4>We included PLWH at the Mbarara Regional Hospital HIV clinic, who were either current alcohol consumers (prior 3 months) or past year abstainers (2:1 enrolment ratio). Participants were recruited for a study of isoniazid preventive therapy for LTBI. TST was performed using 5 tuberculin units of purified protein derivative. The primary outcome was a positive TST reading (≥5mm induration), reflecting LTBI. We used logistic regression analyses to assess the cross-sectional association between self-reported current alcohol use and a positive TST.<h4>Results</h4>Of the 295 of 312 (95%) who returned for TST reading, 63% were females and 63% were current alcohol drinkers. The TST positive prevalence was 27.5% (95% confidence interval [CI]: 22.6% - 32.9%). The odds of a positive TST for current alcohol users compared to abstainers was 0.76 (95% CI: 0.41, 1.41), controlling for gender, age, body mass index, history of smoking, and prior unhealthy alcohol use.<h4>Conclusions</h4>The prevalence of LTBI among PLWH on ART in south-western Uganda was moderate and LTBI poses a risk for future infectious TB. Although alcohol use is common, we did not detect an association between current drinking or prior unhealthy alcohol use and LTBI. Further studies to evaluate the association between LTBI and different levels of current drinking (heavy versus not) are needed.https://doi.org/10.1371/journal.pone.0235261 |
| spellingShingle | Winnie R Muyindike Robin Fatch Debbie M Cheng Nneka I Emenyonu Christine Ngabirano Julian Adong Benjamin P Linas Karen R Jacobson Judith A Hahn Tuberculin skin test positivity among HIV-infected alcohol drinkers on antiretrovirals in south-western Uganda. PLoS ONE |
| title | Tuberculin skin test positivity among HIV-infected alcohol drinkers on antiretrovirals in south-western Uganda. |
| title_full | Tuberculin skin test positivity among HIV-infected alcohol drinkers on antiretrovirals in south-western Uganda. |
| title_fullStr | Tuberculin skin test positivity among HIV-infected alcohol drinkers on antiretrovirals in south-western Uganda. |
| title_full_unstemmed | Tuberculin skin test positivity among HIV-infected alcohol drinkers on antiretrovirals in south-western Uganda. |
| title_short | Tuberculin skin test positivity among HIV-infected alcohol drinkers on antiretrovirals in south-western Uganda. |
| title_sort | tuberculin skin test positivity among hiv infected alcohol drinkers on antiretrovirals in south western uganda |
| url | https://doi.org/10.1371/journal.pone.0235261 |
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