ArticlePeerJ2017
CD4 count and tuberculosis risk in HIV-positive adults not on ART: a systematic review and meta-analysis.
Article in PeerJ, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 37 papers, 3 of them syntheses that pooled it.
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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.
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Who cites it
37 citing papers in PubMed, 3 syntheses or guidelines pooled it, 65 citations in OpenAlex.
- Differences in tuberculosis prevalence by sex in low- and middle-income countries over 1993-2025: A systematic review and meta-analysis.PLoS medicine · 2026Pooled it
- Urban and rural prevalence of tuberculosis in low- and middle-income countries: A systematic review and meta-analysis.PLoS medicine · 2026Pooled it
- Tuberculosis and its association with CD4BMC infectious diseases · 2020Pooled it
- Calcitriol supplementation accelerates the recovery of patients with tuberculosis who have vitamin D deficiency: a randomized, single-blind, controlled clinical trial.BMC infectious diseases · 2022Trial
- Effect of isoniazid preventive therapy on tuberculosis incidence and its predictors among adult patients enrolled in antiretroviral therapy at public health facilities in Ambo Town, Oromia, Ethiopia: a retrospective cohort study.BMC infectious diseases · 2026Article
- HIV inhibits Warburg metabolism in human macrophages infected with Mycobacterium tuberculosis.Scientific reports · 2026Article
- The Role of Type I Interferons in Tuberculosis and in Tuberculosis-Risk-Associated Comorbidities.Infectious disease reports · 2025Review
- The delivery of new tuberculosis vaccines to people living with HIV - when to vaccinate?BMC infectious diseases · 2025Article
- Trends in prevalent TB among persons enrolling for HIV care before and after 'Test and Treat' across East-Africa.IJTLD open · 2025Article
- Tuberculosis and HIV coinfection: Progress and challenges towards reducing incidence and mortality.International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases · 2025Review
- Navigating HIV care in a mobile society: case studies of clinic transfers in South Africa's public health sector.AIDS care · 2025Article
- Immune correlates of early clearance of Mycobacterium tuberculosis among tuberculosis household contacts in Indonesia.Nature communications · 2025Article
- Clinico-radiological characteristics and lethality of HIV-tuberculosis coinfection in the Infectiology ward of the Libreville University Hospital, Gabon.Southern African journal of infectious diseases · 2025Article
- Data-driven targets for predicting outcomes in patients with HIV infection and tuberculous meningitis in China.BMJ neurology open · 2025Article
- Investigating the Determinants of Mortality before CD4 Count Recovery in a Cohort of Patients Initiated on Antiretroviral Therapy in South Africa Using a Fine and Gray Competing Risks Model.Tropical medicine and infectious disease · 2024Article
- Article
- HIV co-infection is associated with reduced Mycobacterium tuberculosis transmissibility in sub-Saharan Africa.PLoS pathogens · 2024Article
- A retrospective study of tuberculosis prevalence and associated factors among HIV-positive key populations in Nigeria.PLOS global public health · 2024Article
- Epidemiology, pathogenesis, clinical presentation and management of TB in patients with HIV and diabetes.The international journal of tuberculosis and lung disease : the official journal of the International Union against Tuberculosis and Lung Disease · 2023Article
- Transmission modeling to infer tuberculosis incidence prevalence and mortality in settings with generalized HIV epidemics.Nature communications · 2023Article
Corrections and comments
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Authors and funding
3 authors at 1 institution in 1 country.
Funding
Abstract
backgroundCD4 cell count in adults with human immunodeficiency virus (HIV) infection (PLHIV) not receiving antiretroviral therapy (ART) influences tuberculosis (TB) risk. Despite widespread use in models informing resource allocation, this relationship has not been systematically reviewed.
methodsWe systematically searched MEDLINE, Aidsinfo, Cochrane review database and Google Scholar for reports in English describing TB incidence stratified by updated CD4 cell count in cohorts of HIV-positive adults (age ≥15 years) not on ART (PROSPERO protocol no: CRD42016048888). Among inclusion criteria were: reporting precision for TB incidence, repeated CD4 measurements, and TB incidence reported for those not on ART or monotherapy. Study quality was assessed via the Newcastle-Ottawa tool for cohort studies. A Bayesian hierarchical model was fitted to estimate the pooled factor increase in TB incidence with respect to CD4 cell count decrement.
resultsA total of 1,555 distinct records were identified from which 164 full text articles were obtained. Common reasons for exclusion of full texts were: no valid TB incidence, no repeat CD4 measurements, and not reporting TB incidence by ART status. The seven studies included reported on 1,206 TB cases among 41,271 individuals, with a typical median follow-up of four years. Studies were generally rated as moderate or high quality. Our meta-analysis estimated a 1.43 (95% credible interval: 1.16-1.88)-fold increase in TB incidence per 100 cells per mm DISCUSSION: Our analysis confirms previous estimates of exponential increase in TB incidence with declining CD4 cell count in adults, emphasizing the importance of early ART initiation to reduce TB risk in PLHIV.
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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.