ArticleJournal of the International AIDS Society2017
HIV viral load as an independent risk factor for tuberculosis in South Africa: collaborative analysis of cohort studies.
Article in Journal of the International AIDS Society, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 32 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
32 citing papers in PubMed, 1 synthesis or guideline pooled it, 48 citations in OpenAlex.
- Virologic failure and its determinants among HIV patients progress towards the third 95% global target in Ethiopia: a systematic review and meta-analysis.BMC infectious diseases · 2026Pooled it
- Tissue-resident-like CD4+ T cells secreting IL-17 control Mycobacterium tuberculosis in the human lung.The Journal of clinical investigation · 2021Trial
- Prevalence and associated factors of tuberculosis/HIV coinfection among people living with HIV in Almaty, Kazakhstan: a cross-sectional study.Frontiers in public health · 2026Article
- Determinants of HIV-1 virologic suppression in HIV-associated tuberculosis in Brazil.Memorias do Instituto Oswaldo Cruz · 2026Observational
- Implications of progressive lung damage and post-tuberculosis sequelae for the health benefits of prompt tuberculosis treatment in high HIV prevalence settings: a mathematical modelling analysis.The Lancet. Global health · 2025Article
- High Incidence of Tuberculosis in Young Children Living With HIV in the Western Cape, South Africa.Journal of acquired immune deficiency syndromes (1999) · 2025Article
- Non-communicable diseases and resistant tuberculosis, a growing burden among people living with HIV in Eastern Kenya.PLOS global public health · 2025Article
- Genetic Diversity ofPathogens (Basel, Switzerland) · 2024Article
- HIV replication and tuberculosis risk among people living with HIV in Europe: A multicohort analysis, 1983-2015.PloS one · 2024Article
- Observational
- Bayesian parametric modeling of time to tuberculosis co-infection of HIV/AIDS patients at Jimma Medical Center, Ethiopia.Scientific reports · 2022Article
- Predictors for tuberculosis co-infection in people living with HIV/AIDs.African health sciences · 2021Article
- Adoption of evidence-informed guidelines in prescribing protease inhibitors for HIV-Tuberculosis co-infected patients on rifampicin and effects on HIV treatment outcomes in Uganda.BMC infectious diseases · 2021Article
- No need for secondary Pneumocystis jirovecii pneumonia prophylaxis in adult people living with HIV from Europe on ART with suppressed viraemia and a CD4 cell count greater than 100 cells/µL.Journal of the International AIDS Society · 2021Observational
- Incidence Rate and Risk Factors for Tuberculosis among People Living with HIV: A 2015-2017 Cohort from Tashkent, Uzbekistan.International journal of environmental research and public health · 2021Article
- Joint Modeling of Incidence of Tuberculosis and Change in Viral Load Over Time Among Adult HIV/AIDS Patients on Anti-Retroviral Therapy at Zewditu Memorial Hospital in Addis Ababa, Ethiopia.HIV/AIDS (Auckland, N.Z.) · 2021Article
- Factors Associated with Viral Suppression Among Adolescents on Antiretroviral Therapy in Homa Bay County, Kenya: A Retrospective Cross-Sectional Study.HIV/AIDS (Auckland, N.Z.) · 2021Article
- Diagnosis of latent tuberculosis infection is associated with reduced HIV viral load and lower risk for opportunistic infections in people living with HIV.PLoS biology · 2020Article
- Increased Prevalence of Liver Fibrosis and HIV Viremia among Patients with HIV, HBV, and Tuberculosis in Botswana.Pathogens (Basel, Switzerland) · 2020Article
- TheFuture virology · 2020Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
12 authors at 7 institutions in 3 countries.
Funding
Abstract
introductionChronic immune activation due to ongoing HIV replication may lead to impaired immune responses against opportunistic infections such as tuberculosis (TB). We studied the role of HIV replication as a risk factor for incident TB after starting antiretroviral therapy (ART).
methodsWe included all HIV-positive adult patients (≥16 years) in care between 2000 and 2014 at three ART programmes in South Africa. Patients with previous TB were excluded. Missing CD4 cell counts and HIV-RNA viral loads at ART start (baseline) and during follow-up were imputed. We used parametric survival models to assess TB incidence (pulmonary and extrapulmonary) by CD4 cell and HIV-RNA levels, and estimated the rate ratios for TB by including age, sex, baseline viral loads, CD4 cell counts, and WHO clinical stage in the model. We also used Poisson general additive regression models with time-updated CD4 and HIV-RNA values, adjusting for age and sex.
resultsWe included 44,260 patients with a median follow-up time of 2.7 years (interquartile range [IQR] 1.0-5.0); 3,819 incident TB cases were recorded (8.6%). At baseline, the median age was 34 years (IQR 28-41); 30,675 patients (69.3%) were female. The median CD4 cell count was 156 cells/µL (IQR 79-229) and the median HIV-RNA viral load 58,000 copies/mL (IQR 6,000-240,000). Overall TB incidence was 26.2/1,000 person-years (95% confidence interval [CI] 25.3-27.0). Compared to the lowest viral load category (0-999 copies/mL), the adjusted rate ratio for TB was 1.41 (95% CI 1.15-1.75,
conclusionsOur results indicate that ongoing HIV replication is an important risk factor for TB, regardless of CD4 cell counts, and underline the importance of early ART start and retention on ART.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.