Tuberculosis incidence in HIV/AIDS patients in Israel, 1983-2010.
OBJECTIVES: People living with HIV/AIDS (PLWHA) who develop tuberculosis disease are at greater mortality-risk. This study aimed to assess tuberculosis disease incidence among all PLWHA in Israel and identify populations at high-risk for developing tuberculosis. DESIGN AND METHODS: Retrospective coh...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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Public Library of Science (PLoS)
2013-01-01
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| Series: | PLoS ONE |
| Online Access: | http://europepmc.org/articles/PMC3836879?pdf=render |
| _version_ | 1818267581914546176 |
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| author | Zohar Mor Moshe Lidji Noa Cedar Itamar Grotto Daniel Chemtob |
| author_facet | Zohar Mor Moshe Lidji Noa Cedar Itamar Grotto Daniel Chemtob |
| author_sort | Zohar Mor |
| collection | DOAJ |
| description | OBJECTIVES: People living with HIV/AIDS (PLWHA) who develop tuberculosis disease are at greater mortality-risk. This study aimed to assess tuberculosis disease incidence among all PLWHA in Israel and identify populations at high-risk for developing tuberculosis. DESIGN AND METHODS: Retrospective cohort-study based on the National HIV and Tuberculosis Registries, which were cross-matched and followed for the last 28-years. PLWHA who developed tuberculosis were compared to those who did not by the Cox-proportional analysis to generate hazard-ratios, and survival-analysis was performed by Log-Rank test. RESULTS: Of all the 6579 PLWHA reported between 1983 and 2010, corresponding to 55737 person-years, 384 (5.8%) developed tuberculosis. Of those, 14 were Israeli-born and 370 were non-Israeli born. The overall tuberculosis incidence-density was 6.9 cases/1000 person-years (95% CI 1.8-12.0). The cumulative tuberculosis-incidence among PLWHA in 2010 was 586 times higher than in HIV-negative individuals (3400 and 5.8 cases per 100000 population, respectively). Higher hazard-ratios to developing tuberculosis were found in migrant citizens PLWHA who were males, non-Israeli born, those who were diagnosed with HIV/AIDS after 1997, those who originated in high-tuberculosis prevalence country and those who acquired HIV by heterosexual or drug-injection transmission. PLWHA who developed tuberculosis had higher odds of dying than other PLWHA (36.5% and 16.6%, respectively, p<0.001, odds ratio = 2.8, 95% confidence-interval 2.3-3.6). In survival-analysis, time to develop tuberculosis was shorter among males than females, in PLWHA who were reported with HIV after 1997, in heterosexual who originated in high-tuberculosis countries, followed by injecting drug-users, heterosexual from low-tuberculosis burden countries and men who have sex with men. CONCLUSION: Tuberculosis-incidence is higher among non-Israeli born PLWHA, with decreasing trends from 1991. Despite the moderate TB-rate disease among PLWHA, it remains an important cause for severe morbidity and mortality. Tuberculosis in PLWHA reflects mainly the tuberculosis-burden in the originating country and possibly also the mode of HIV-transmission. |
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| institution | Directory Open Access Journal |
| issn | 1932-6203 |
| language | English |
| last_indexed | 2024-12-12T20:24:53Z |
| publishDate | 2013-01-01 |
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| spelling | doaj.art-faa3eb3257294f80af82cb9939ec45672022-12-22T00:13:10ZengPublic Library of Science (PLoS)PLoS ONE1932-62032013-01-01811e7969110.1371/journal.pone.0079691Tuberculosis incidence in HIV/AIDS patients in Israel, 1983-2010.Zohar MorMoshe LidjiNoa CedarItamar GrottoDaniel ChemtobOBJECTIVES: People living with HIV/AIDS (PLWHA) who develop tuberculosis disease are at greater mortality-risk. This study aimed to assess tuberculosis disease incidence among all PLWHA in Israel and identify populations at high-risk for developing tuberculosis. DESIGN AND METHODS: Retrospective cohort-study based on the National HIV and Tuberculosis Registries, which were cross-matched and followed for the last 28-years. PLWHA who developed tuberculosis were compared to those who did not by the Cox-proportional analysis to generate hazard-ratios, and survival-analysis was performed by Log-Rank test. RESULTS: Of all the 6579 PLWHA reported between 1983 and 2010, corresponding to 55737 person-years, 384 (5.8%) developed tuberculosis. Of those, 14 were Israeli-born and 370 were non-Israeli born. The overall tuberculosis incidence-density was 6.9 cases/1000 person-years (95% CI 1.8-12.0). The cumulative tuberculosis-incidence among PLWHA in 2010 was 586 times higher than in HIV-negative individuals (3400 and 5.8 cases per 100000 population, respectively). Higher hazard-ratios to developing tuberculosis were found in migrant citizens PLWHA who were males, non-Israeli born, those who were diagnosed with HIV/AIDS after 1997, those who originated in high-tuberculosis prevalence country and those who acquired HIV by heterosexual or drug-injection transmission. PLWHA who developed tuberculosis had higher odds of dying than other PLWHA (36.5% and 16.6%, respectively, p<0.001, odds ratio = 2.8, 95% confidence-interval 2.3-3.6). In survival-analysis, time to develop tuberculosis was shorter among males than females, in PLWHA who were reported with HIV after 1997, in heterosexual who originated in high-tuberculosis countries, followed by injecting drug-users, heterosexual from low-tuberculosis burden countries and men who have sex with men. CONCLUSION: Tuberculosis-incidence is higher among non-Israeli born PLWHA, with decreasing trends from 1991. Despite the moderate TB-rate disease among PLWHA, it remains an important cause for severe morbidity and mortality. Tuberculosis in PLWHA reflects mainly the tuberculosis-burden in the originating country and possibly also the mode of HIV-transmission.http://europepmc.org/articles/PMC3836879?pdf=render |
| spellingShingle | Zohar Mor Moshe Lidji Noa Cedar Itamar Grotto Daniel Chemtob Tuberculosis incidence in HIV/AIDS patients in Israel, 1983-2010. PLoS ONE |
| title | Tuberculosis incidence in HIV/AIDS patients in Israel, 1983-2010. |
| title_full | Tuberculosis incidence in HIV/AIDS patients in Israel, 1983-2010. |
| title_fullStr | Tuberculosis incidence in HIV/AIDS patients in Israel, 1983-2010. |
| title_full_unstemmed | Tuberculosis incidence in HIV/AIDS patients in Israel, 1983-2010. |
| title_short | Tuberculosis incidence in HIV/AIDS patients in Israel, 1983-2010. |
| title_sort | tuberculosis incidence in hiv aids patients in israel 1983 2010 |
| url | http://europepmc.org/articles/PMC3836879?pdf=render |
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