ArticleBMC infectious diseases2022
Incidence and factors associated with active tuberculosis among people living with HIV after long-term antiretroviral therapy in Thailand: a competing risk model.
Article in BMC infectious diseases, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers, 1 of them a synthesis that pooled it.
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Who cites it
7 citing papers in PubMed, 1 synthesis or guideline pooled it, 10 citations in OpenAlex.
- Undernutrition as a risk factor for tuberculosis disease.The Cochrane database of systematic reviews · 2024Pooled it
- Factors associated with depression among tuberculosis patients with HIV co-infection in rural community Thailand.BMC psychology · 2026Article
- The Dynamics of Human Cytomegalovirus Markers in Tuberculosis Disease Among People With Human Immunodeficiency Virus on Long-term Antiretroviral Therapy: A Nested Case-Control Study.Open forum infectious diseases · 2026Article
- Diagnostic Modality Influences Tuberculosis Detection in People Living with HIV: Eight Years of Data from a Thai Referral Center.Diagnostics (Basel, Switzerland) · 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
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Authors and funding
7 authors at 3 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundAntiretroviral therapy (ART) is known to reduce tuberculosis (TB) incidence among people living with HIV (PLWH). However, studies describing the impact of long-term ART and CD4 count recovery on TB incidence remain scarce due to limited follow up in previous studies. We evaluated TB incidence in a long-term cohort of PLWH on ART in Thailand.
methodsWe conducted an analysis of PLWH aged ≥ 18 years who started ART between 1996 and December 2020. Participants were followed up every 6 months for routine HIV care. TB risk factors, body mass index (BMI), physical examination and full differential blood counts were evaluated at each clinic visit, and CD4 cell counts and HIV RNA every 12 months. Participants diagnosed with TB > 3 months after starting ART were classified as incident cases. Time to event models with death as a competing risk, were used to derive the TB cumulative incidence function (CIF) after ART initiation, and assess time-updated factors associated with incident TB using a six month lag.
resultsA total of 2,636 PLWH contributing 24,229 person years (PY) of follow-up on ART were analysed. Median age was 32.0 (IQR 27.4-37.6) years; 67.5% were male. Median CD4 cell count at ART initiation was 264 (IQR 167-379) cells/mm
conclusionDespite a marked reduction in TB incidence following ART, ongoing TB risk remains high among PLWH, despite long-term suppressive ART. Those with low CD4 cell counts, who are underweight, or currently having substance abuse should be carefully monitored.
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