Evidence map›Paper›PMID 28743248›Full record

ArticleBMC infectious diseases2017

Immunological recovery in tuberculosis/HIV co-infected patients on antiretroviral therapy: implication for tuberculosis preventive therapy.

Basel Karo, Gérard Krause, Stefanie Castell, Christian Kollan, Osamah Hamouda, Walter Haas, ClinSurv HIV Study Group

Abstract readMulticenter Study
In one paragraph

Article in BMC infectious diseases, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers.

0numbers the graph read from it
0cells of the map it votes in
12citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

12 citing papers in PubMed.

  1. Article
  2. Article
  3. Article
  4. Article
  5. Article
  6. Observational
  7. Article
  8. Article
  9. Article
  10. Article
  11. Article
  12. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Basel KaroDepartment for Infectious Disease Epidemiology, Robert Koch Institute (RKI), Seestr. 10, 13353, Berlin, Germany. karob@rki.de.ORCID 0000-0003-2178-1654
Gérard KrauseDepartment of Epidemiology, Helmholtz Centre for Infection Research (HZI), Braunschweig, Germany.
Stefanie CastellDepartment of Epidemiology, Helmholtz Centre for Infection Research (HZI), Braunschweig, Germany.
Christian KollanDepartment for Infectious Disease Epidemiology, Robert Koch Institute (RKI), Seestr. 10, 13353, Berlin, Germany.
Osamah HamoudaDepartment for Infectious Disease Epidemiology, Robert Koch Institute (RKI), Seestr. 10, 13353, Berlin, Germany.
Walter HaasDepartment for Infectious Disease Epidemiology, Robert Koch Institute (RKI), Seestr. 10, 13353, Berlin, Germany.
ClinSurv HIV Study Group

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundUnderstanding the immune response to combination antiretroviral therapy (cART) is essential for a clear approach to tuberculosis (TB) preventive therapy. We investigated the immunological recovery in cART-treated HIV-infected patients developing TB compared to those who remained free of TB.

methodsWe extracted data of HIV-infected patients from a multicenter cohort for the HIV clinical surveillance in Germany. No patients included in our study had TB at the beginning of the observation. Using a longitudinal mixed model, we assessed the differences in the mean change of biomarkers (CD4+ cell count, CD8+ cell count, CD4:CD8 ratio and viral load) since cART initiation in patients who remained free of TB vs. those developing TB. To detect the best-fit trajectories of the immunological biomarkers, we applied a multivariable fractional polynomials model.

resultsWe analyzed a total of 10,671 HIV-infected patients including 139 patients who developed TB during follow-up. The highest TB incidences were observed during the first two years since cART initiation (0.32 and 0.50 per 100 person-years). In an adjusted multivariable mixed model, we found that the average change in CD4+ cell count recovery was significantly greater by 33 cells/μl in patients who remained free of TB compared with those developing TB. After the initial three months of cART, 65.6% of patients who remaining free of TB achieved CD4+ count of ≥400 cells/μl, while only 11.3% of patients developing TB reached this immunological status after the three months of cART. We found no differences in the average change of CD8+ cell count, CD4:CD8 ratio or viral load between the two-patient groups.

conclusionAll HIV-infected patients responded to cART. However, patients developing TB showed reduced recovery in CD4+ cell count and this might partly explain the incident TB in HIV-infected patients receiving cART. These findings reinforce the importance of adjunctive TB preventive therapy for patients with reduced recovery in CD4+ cell count.

Indexed as

AdultAIDS-Related Opportunistic InfectionsAntibiotic ProphylaxisAntiretroviral Therapy, Highly ActiveBiomarkersCD4 Lymphocyte CountCD8-Positive T-LymphocytesCohort StudiesCoinfectionFemaleGermanyHIV InfectionsHumansIncidenceMaleMiddle AgedBiomarkersAntiretroviral therapyDeveloped countryHIV/aidsImmune recoveryTuberculosis

Identifiers

PMID28743248
PMCPMC5526303

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

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.