[Accepted Manuscript] The effect of antiretroviral therapy and CD4 count on markers of infectiousness in HIV-associated tuberculosis


van Halsema, C.L.; Fielding, K.L.; Chihota, V.N.; George, E.C.; Lewis, J.J.; Churchyard, G.J.; Grant, A.D.; (2015) [Accepted Manuscript] The effect of antiretroviral therapy and CD4 count on markers of infectiousness in HIV-associated tuberculosis. Journal of acquired immune deficiency syndromes (1999). ISSN 1525-4135 DOI: https://doi.org/10.1097/QAI.0000000000000684

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Abstract

Clinical features of tuberculosis influence infectiousness. This cross-sectional study examined the effect of combination antiretroviral therapy (cART) and CD4 on sputum smear-positivity (SS+) and pulmonary cavitation among 1589 (1185/1589 HIV-positive) miners in South Africa. Proportions SS+ varied nonlinearly by CD4 with greatest proportions SS+ (55.3%) in the lowest stratum (<100 cells/μL). Adjusted prevalence ratio for SS+; on vs. off cART was 0.90 (95% confidence interval: 0.73 to 1.11). Proportions with cavitation varied linearly with CD4, with no independent cART effect (adjusted prevalence ratio 1.17; 95% confidence interval: 0.80 to 1.71). cART did not independently affect SS+ or cavitation but may increase infectiousness through CD4 recovery.

Item Type: Article
Faculty and Department: Faculty of Infectious and Tropical Diseases > Dept of Clinical Research
Faculty of Epidemiology and Population Health > Dept of Infectious Disease Epidemiology
URI: http://researchonline.lshtm.ac.uk/id/eprint/4363370

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