Association of highly active antiretroviral treatment with incident tuberculosis in people living with HIV/AIDS

Yung Feng Yen, I. An Jen, Pei Hung Chuang, Marcelo Chen, Yu Ching Lan, Chun Yuan Lee, Yi Ming Arthur Chen

Research output: Contribution to journalArticle

Abstract

Purpose: To determine the short-term and long-term effects of highly active antiretroviral therapy (HAART) on incident tuberculosis (TB) in people living with HIV/AIDS (PLWHA). Methods: From 2000 to 2012, we identified adult PLWHA from Taiwan Centers for Disease Control HIV Surveillance System. All PLWHA were followed up until December 31, 2012, and observed for TB occurrence. Time-dependent Cox proportional hazards models were used to determine the short-term and long-term effects of HAART on incident TB. Results: Of 20,072 PLWHA, 628 (3.13%) had incident TB, corresponding to an incident rate of 701/100,000 person-years. After adjusting for potential confounders, PLWHA receiving HAART were more likely to develop TB than those not receiving the drugs (adjusted hazard ratio [AHR] 1.56; 95% confidence interval [CI] 1.18–2.05). While the short-term and long-term effects of HAART on incident TB were considered, HAART was a risk factor for TB development within the first 90 days (AHR 6.06; 95% CI 4.58–8.01) and between 90 and 180 days of treatment (AHR 1.80; 95% CI 1.11–2.94) but was a protective factor after 180 days of HAART use (AHR 0.51; 95% CI 0.39–0.66). Conclusions: HAART is a risk factor for the development of TB in the short term but a protective factor in the long term.

Original languageEnglish
Pages (from-to)886-892.e3
JournalAnnals of Epidemiology
Volume28
Issue number12
DOIs
Publication statusPublished - Dec 1 2018
Externally publishedYes

Fingerprint

Highly Active Antiretroviral Therapy
Acquired Immunodeficiency Syndrome
Tuberculosis
HIV
Confidence Intervals
Therapeutics
Centers for Disease Control and Prevention (U.S.)
Taiwan
Proportional Hazards Models
Pharmaceutical Preparations

Keywords

  • Highly active antiretroviral treatment
  • HIV
  • Short-term and long-term risk
  • Tuberculosis

ASJC Scopus subject areas

  • Epidemiology

Cite this

Association of highly active antiretroviral treatment with incident tuberculosis in people living with HIV/AIDS. / Yen, Yung Feng; Jen, I. An; Chuang, Pei Hung; Chen, Marcelo; Lan, Yu Ching; Lee, Chun Yuan; Arthur Chen, Yi Ming.

In: Annals of Epidemiology, Vol. 28, No. 12, 01.12.2018, p. 886-892.e3.

Research output: Contribution to journalArticle

Yen, Yung Feng ; Jen, I. An ; Chuang, Pei Hung ; Chen, Marcelo ; Lan, Yu Ching ; Lee, Chun Yuan ; Arthur Chen, Yi Ming. / Association of highly active antiretroviral treatment with incident tuberculosis in people living with HIV/AIDS. In: Annals of Epidemiology. 2018 ; Vol. 28, No. 12. pp. 886-892.e3.
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abstract = "Purpose: To determine the short-term and long-term effects of highly active antiretroviral therapy (HAART) on incident tuberculosis (TB) in people living with HIV/AIDS (PLWHA). Methods: From 2000 to 2012, we identified adult PLWHA from Taiwan Centers for Disease Control HIV Surveillance System. All PLWHA were followed up until December 31, 2012, and observed for TB occurrence. Time-dependent Cox proportional hazards models were used to determine the short-term and long-term effects of HAART on incident TB. Results: Of 20,072 PLWHA, 628 (3.13{\%}) had incident TB, corresponding to an incident rate of 701/100,000 person-years. After adjusting for potential confounders, PLWHA receiving HAART were more likely to develop TB than those not receiving the drugs (adjusted hazard ratio [AHR] 1.56; 95{\%} confidence interval [CI] 1.18–2.05). While the short-term and long-term effects of HAART on incident TB were considered, HAART was a risk factor for TB development within the first 90 days (AHR 6.06; 95{\%} CI 4.58–8.01) and between 90 and 180 days of treatment (AHR 1.80; 95{\%} CI 1.11–2.94) but was a protective factor after 180 days of HAART use (AHR 0.51; 95{\%} CI 0.39–0.66). Conclusions: HAART is a risk factor for the development of TB in the short term but a protective factor in the long term.",
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