ArticleThe international journal of tuberculosis and lung disease : the official journal of the International Union against Tuberculosis and Lung Disease2013
Impact of human immunodeficiency virus and CD4 count on tuberculosis diagnosis: analysis of city-wide data from Cape Town, South Africa.
Article in The international journal of tuberculosis and lung disease : the official journal of the International Union against Tuberculosis and Lung Disease, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 30 papers.
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30 citing papers in PubMed.
- Toxicity related to standard TB therapy for pulmonary tuberculosis and treatment outcomes in the REMoxTB study according to HIV status.BMC pulmonary medicine · 2019Trial
- Pulmonary complications in people living with HIV: a retrospective evaluation of the etiological spectrum and mortality-associated factors.BMC infectious diseases · 2026Article
- Immune-inflammatory profiles and disease severity in pulmonary tuberculosis complicated by central nervous system tuberculosis.Frontiers in cellular and infection microbiology · 2026Article
- Tertiary Lymphoid Structures in Tuberculosis: Persistence, Protection, and Pathology.Immunological reviews · 2025Review
- Immune mechanisms of granuloma formation in sarcoidosis and tuberculosis.The Journal of clinical investigation · 2024Review
- More thanThorax · 2023Article
- Vaccine development against tuberculosis before and after Covid-19.Frontiers in immunology · 2023Review
- Immune cell interactions in tuberculosis.Cell · 2022Review
- Stages of pregnancy and HIV affect diagnosis of tuberculosis infection and Mycobacterium tuberculosis (MTB)-induced immune response: Findings from PRACHITi, a cohort study in Pune, India.International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases · 2021Article
- Accuracy and Incremental Yield of the Chest X-Ray in Screening for Tuberculosis in Uganda: A Cross-Sectional Study.Tuberculosis research and treatment · 2021Article
- Clinical, radiological, and laboratory predictors of a positive urine lipoarabinomannan test in sputum-scarce and sputum-negative patients with HIV-associated tuberculosis in two Johannesburg hospitals.Southern African journal of HIV medicine · 2021Article
- SIV and Mycobacterium tuberculosis synergy within the granuloma accelerates the reactivation pattern of latent tuberculosis.PLoS pathogens · 2020Article
- A Four-Year Hospital-Based Retrospective Study of the Predictors of Tuberculosis in People Living with HIV and Receiving Care at Bamenda Regional Hospital, Cameroon.International journal of MCH and AIDS · 2020Article
- Diagnosis and clinical outcomes of extrapulmonary tuberculosis in antiretroviral therapy programmes in low- and middle-income countries: a multicohort study.Journal of the International AIDS Society · 2019Article
- An Inflammatory Story: Antibodies in Tuberculosis Comorbidities.Frontiers in immunology · 2019Review
- Modeling tuberculosis dynamics with the presence of hyper-susceptible individuals for Ho Chi Minh City from 1996 to 2015.BMC infectious diseases · 2018Article
- Prevalence of extrapulmonary tuberculosis among people living with HIV/AIDS in sub-Saharan Africa: a systemic review and meta-analysis.HIV/AIDS (Auckland, N.Z.) · 2018Review
- Article
- Effect of HIV on the Frequency and Number of Mycobacterium tuberculosis-Specific CD4+ T Cells in Blood and Airways During Latent M. tuberculosis Infection.The Journal of infectious diseases · 2017Article
- A clinical scoring system to prioritise investigation for tuberculosis among adults attending HIV clinics in South Africa.PloS one · 2017Article
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6 authors.
Funding
Abstract
backgroundThe impact of human immunodeficiency virus (HIV) infection and CD4 count on the diagnosis of tuberculosis (TB) at population level is incompletely defined.
objectiveTo determine how HIV infection and CD4 count affect disease site, sputum smear status and overall rate of laboratory confirmation (sputum smear microscopy or culture) of TB cases under routine programme conditions.
designRetrospective analysis of the 2009 electronic TB register for Cape Town, South Africa.
resultsOf 29,478 TB cases notified in 2009, HIV status was known for 25,744 (87.3%) cases, of whom 13,237 (51.4%) were HIV-positive. Of these, 61.2% had CD4 cell counts of <200 cells/μl and 82.7% had counts of <350 cells/μl. Laboratory confirmation of TB (by smear or culture) was obtained less frequently in HIV-infected than non-HIV-infected adult cases (53.9% vs. 74.3%, P< 0.001). HIV infection was associated with a higher proportion of sputum smear-negative and extra-pulmonary TB and lower grades of sputum smear positivity even among those with CD4 counts of ≥ 500 cells/μl. However, the relationship between the proportion of smear-positive cases and CD4 count was non-linear.
conclusionMuch TB is not laboratory-confirmed in this setting despite good laboratory services. HIV-associated TB is more difficult to diagnose even at high CD4 cell counts of >500 cells/μl, suggesting early impact after HIV seroconversion.
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