Latent Tuberculosis Infection and Associated Risk Factors among People Living with HIV and HIV-Uninfected Individuals in Lithuania

Author:

Matulyte Elzbieta1,Kancauskiene Zavinta2,Kausas Aidas3,Urboniene Jurgita4,Lipnickiene Vilnele5,Kopeykiniene Jelena6,Gudaitis Tomas7,Raudonis Sarunas7,Danila Edvardas89,Costagliola Dominique10,Matulionyte Raimonda1

Affiliation:

1. Department of Infectious Diseases and Dermatovenerology, Faculty of Medicine, Vilnius University Hospital Santaros Klinikos, Vilnius University, LT-08410 Vilnius, Lithuania

2. Department of Infectious Diseases, University Hospital of Klaipeda, LT-92888 Klaipeda, Lithuania

3. Adult Infectious Diseases Unit, Clinic of Conservative Medicine, Republican Siauliai County Hospital, LT-76231 Siauliai, Lithuania

4. Centre of Infectious Diseases, Vilnius University Hospital Santaros Klinikos, LT-08410 Vilnius, Lithuania

5. National Public Health Surveillance Laboratory, LT-10210 Vilnius, Lithuania

6. Department of Diagnostics, University Hospital of Klaipeda, LT-92888 Klaipeda, Lithuania

7. Faculty of Medicine, Vilnius University, LT-03101 Vilnius, Lithuania

8. Faculty of Medicine, Institute of Clinical Medicine, Clinic of Chest Diseases, Immunology, and Allergology, Vilnius University, LT-03101 Vilnius, Lithuania

9. Centre of Pulmonology and Allergology, Vilnius University Hospital Santaros Klinikos, LT-08661 Vilnius, Lithuania

10. Institut Pierre Louis Épidémiologie de Santé Publique, Sorbonne Université, INSERM, F75013 Paris, France

Abstract

Background: People living with HIV (PLHIV) with latent tuberculosis infection (LTBI) are at increased risk of tuberculosis (TB) reactivation compared to the HIV-negative population. Lithuania belongs to the 18 high-priority TB countries in the European region. The aim of this study was to compare the prevalence of LTBI and LTBI-related risk factors between PLHIV and HIV-uninfected populations. Methods: A cross-sectional study was conducted in three Lithuanian Infectious Diseases centres from August 2018 to May 2022 using the interferon gamma release assay (IGRA) and tuberculin skin test (TST) in Vilnius, and IGRA only in Siauliai and Klaipeda. Cohen’s kappa was used to assess IGRA and TST agreement. A structured questionnaire was completed by the study participants. LTBI-related risk factors were identified using a multivariable logistic regression model. Results: In total, 391 PLHIV and 443 HIV-uninfected individuals enrolled, with a median age of 41 (IQR 36–48) and 43 (IQR 36–50), consisting of 69.8% and 65.5% male, respectively. The prevalence of LTBI defined by positive IGRA and/or TST among PLHIV was higher compared to that in the HIV-uninfected population (20.5% vs. 15.3%; OR 1.42; 95% CI 1.02–2.03; p = 0.04). The concordance between IGRA and TST was fair: kappa = 0.23 (95% CI 0.09–0.34). In multivariable analyses, association with injecting drug use (IDU) (ORa 2.25, 95% CI 1.27–3.99, p = 0.01) and imprisonment (ORa 1.99, 95% CI 1.13–3.52, p = 0.02) in all participants, IDU (ORa 2.37, 95% CI 1.09–5.15; p = 0.029) in PLHIV and a history of contact with an active TB patient (ORa 3.33, 95% CI 1.53–7.24; p = 0.002) in HIV-uninfected individuals were significant associations evidenced by LTBI. Conclusions: The prevalence of LTBI among PLHIV in Lithuania is higher compared to that in the HIV-uninfected population and the European average. The association with IDU in PLHIV emphasizes the need for integrated HIV, TB and substance abuse treatment to provide patient-centred care.

Funder

Run-up to programmatic management of latent tuberculosis infection in HIV-infected people in Lithuania

Western-Eastern European Partnership Initiative on HIV, Viral Hepatitis and TB

Publisher

MDPI AG

Subject

Infectious Diseases,Microbiology (medical),General Immunology and Microbiology,Molecular Biology,Immunology and Allergy

Reference49 articles.

1. WHO (2021). Global Tuberculosis Report 2021.

2. European Centre for Disease Prevention and Control/WHO Regional Office for Europe (2021). HIV/AIDS Surveillance in Europe 2021–2020 Data, World Health Organization.

3. Kaef, C., Benzon, A., Panteleev, A., Skrahina, A., Bolokadze, N., Tetradov, S., Podlasin, R., Karpov, I., Borodulina, E., and Denisova, E. (2021). Delayed diagnosis of tuberculosis in persons living with HIV in Eastern Europe: Associated factors and effect on mortality—A multicentre prospective cohort study. BMC Infect. Dis., 21.

4. WHO (2018). Latent Tuberculosis Infection: Updated and Consolidated Guidelines for Programmatic Management, Licence: CC BY-NC-SA 3.0 IGO.

5. Consensus statement. Global burden of tuberculosis: Estimated incidence, prevalence, and mortality by country. WHO Global Surveillance and Monitoring Project;Dye;J. Am. Med. Assoc.,1999

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