Factors associated with latent tuberculosis infection among HIV positive adults ≥ 18 years in South Africa in 2016 - 2017: a cross-sectional study
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Date
2021
Authors
Nagudi, Galenda Jeniffer
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Abstract
Introduction: Latent tuberculosis infection (LTBI) is a major public health concern as it is one
of the main sources of Tuberculosis (TB). Approximately 10% of individuals with LTBI will
develop TB disease. HIV infected individuals are among the populations at highest risk of
LTBI and progressing to active TB disease. Understanding prevalence and risk factors of LTBI
is important in guiding implementation of strategies such as TB preventive therapy (TPT) and
vaccination. The main aim of this study was to estimate factors associated with LTBI among
HIV positive adults in South Africa.
Methods: Secondary data analyses were conducted on baseline data of HIV-positive adults
enrolled for the WHIP3 TB trial conducted in South Africa in 2016-2017. Participants’ medical
history, vital signs, CD4 count, and QuantiFERON-TB (QFT) results were collected through
self-reporting, physical examination, medical records, and LTBI blood testing respectively.
Descriptive statistics and logistic regression analysis using Stata 15® were used to describe the
study population and determine factors associated with LTBI and CD8+ T-cell response.
Results: 1087 of 2511 study participants tested positive, giving a 43.3% LTBI prevalence.
Higher LTBI prevalence was associated with increasing age (OR 1.01 [95%CI 1.0;1.03]),
having a previous TB diagnosis (OR 1.34 [95%CI 1.10;1.63]) and having a CD4 count >
200cells/mL3
(OR 1.60 [95%CI 1.25;2.05]). CD8+ T-cell response was associated with having
a previous TB diagnosis (OR 1.85 [95%CI 1.35;2.53]).
Conclusion: Given the high prevalence of LTBI among HIV infected adults in South Africa,
findings of this study should guide implementation of TPT and facilitate planning of the
vaccine trials.
Description
A research report submitted in partial fulfilment of the requirements for the degree of Master of Science in Epidemiology in the field of Epidemiology and Biostatistics to the Faculty of Health Sciences, School of Public Health, University of the Witwatersrand, Johannesburg, 2021