| Author | Grinsztejn, Eduarda | |
| Author | Cardoso, Sandra Wagner | |
| Author | Velasque, Luciane | |
| Author | Hoagland, Brenda | |
| Author | Santos, Desiree Gomes dos | |
| Author | Coutinho, Carolina | |
| Author | Silva, Simone da Costa Cruz | |
| Author | Nazer, Sandro Coutinho | |
| Author | Ferreira, Ana Cristina Garcia | |
| Author | Castilho, Jessica | |
| Author | Grinsztejn, Beatriz | |
| Author | Veloso, Valdiléa G. | |
| Access date | 2023-12-28T15:50:09Z | |
| Available date | 2023-12-28T15:50:09Z | |
| Document date | 2023 | |
| Citation | GRINSZTEJN, Eduarda et al. Impact of Latent M. tuberculosis Infection Treatment on Time to CD4/CD8 Recovery in Acute, Recent, and Chronic HIV Infection. Journal of Acquired Immune Deficiency Syndromes, v. 94, n. 4, p. 355-363, Dec. 2023. | en_US |
| ISSN | 1525-4135 | en_US |
| URI | https://www.arca.fiocruz.br/handle/icict/62020 | |
| Language | eng | en_US |
| Publisher | Lippincott Williams & Wilkins | en_US |
| Rights | open access | en_US |
| Title | Impact of Latent M. tuberculosis Infection Treatment on Time to CD4/CD8 Recovery in Acute, Recent, and Chronic HIV Infection | en_US |
| Type | Article | en_US |
| DOI | 10.1097/QAI.0000000000003284 | |
| Abstract | Introduction: In people living with HIV, active and latent tubercu losis (TB) coinfections are associated with immune activation that correlate with HIV progression and mortality. We investigated the effect of initiating antiretroviral therapy (ART) during acute (AHI), recent (RHI), or chronic HIV infection (CHI) on CD4/CD8 ratio normalization and associated factors, the impact of latent TB infection treatment, andprior/concomitant TB diagnosis at the time of ART initiation. Methods: We included sex with men and transgender women individuals initiating ART with AHI, RHI and CHI between 2013 and 2019, from a prospective cohort in Brazil. We compared time from ART initiation to the first normal CD4/CD8 ratio (CD4/CD8 $1) using Kaplan–Meier curves and multivariable Cox proportional hazards models. Sociodemographic and clinical variables were explored. Variables with P values ,0.20 in univariable analyses were included in multivariable analyses. Results: Five hundred fifty participants were included, 11.8% classified as AHI and 6.4% as RHI, 46.7% with CHI-CD4 cell counts $350 cells/mm3 and 35.1% with CHI-CD4 cell counts ≥350 cells/mm3. Time to normalization was shortest among AHI patients, followed by RHI and CHI individuals with higher baseline CD4. In the multivariable model, AHI was associated with a six-fold increased likelihood of achieving a CD4/CD8 ratio $1 (hazard ratio [HR]: 6.03; 95% confidence interval [CI]: 3.70 to 9.82; P , 0.001), RHI with HR: 4.47 (95% CI: 2.57 to 7.76; P , 0.001), and CHI CD4 $350 cells/mm3 with HR: 1.87 (95% CI: 1.24 to 2.84; P = 0.003). Latent TB infection treatment was significantly associated with a higher likelihood of the outcome (HR: 1.79; 95% CI: 1.22 to 2.62; P = 0.003). Previous history or concomitant active TB at ART initiation was associated with a lower likelihood of the outcome (HR: 0.41; 95% CI: 0.16 to 1.02; P = 0.054). Conclusions: Initiating ART early during AHI may offer an opportunity to mitigate immune damage. Efforts to implement HIV diagnosis and ART initiation during AHI are critical to amplify ART benefits. | en_US |
| Affilliation | University Hospitals Seidman Cancer Center. Department of Hematology-Oncology. Cleveland, OH. | en_US |
| Affilliation | Fundação Oswaldo Cruz. Instituto de Pesquisa Clínica Evandro Chagas. Rio de Janeiro, RJ, Brasil. | en_US |
| Affilliation | Universidade Federal do Estado do Rio de Janeiro. Departamento de Matemática e Estatística. Rio de Janeiro, RJ, Brasil. | en_US |
| Affilliation | Fundação Oswaldo Cruz. Instituto de Pesquisa Clínica Evandro Chagas. Rio de Janeiro, RJ, Brasil. | en_US |
| Affilliation | Fundação Oswaldo Cruz. Instituto de Pesquisa Clínica Evandro Chagas. Rio de Janeiro, RJ, Brasil. | en_US |
| Affilliation | Fundação Oswaldo Cruz. Instituto de Pesquisa Clínica Evandro Chagas. Rio de Janeiro, RJ, Brasil. | en_US |
| Affilliation | Fundação Oswaldo Cruz. Instituto de Pesquisa Clínica Evandro Chagas. Rio de Janeiro, RJ, Brasil. | en_US |
| Affilliation | Fundação Oswaldo Cruz. Instituto de Pesquisa Clínica Evandro Chagas. Rio de Janeiro, RJ, Brasil. | en_US |
| Affilliation | Ministério da Saúde. Secretaria de Vigilância em Saúde. Departamento de Doenças de Condições Crônicas e Infecções Sexualmente Transmissíveis. Coordenação Geral de Aids e Hepatites Virais. Brasília, DF, Brasil / Fundação Oswaldo Cruz. Instituto de Pesquisa Clínica Evandro Chagas. Rio de Janeiro, RJ, Brasil. | en_US |
| Affilliation | Vanderbilt University. Nashville, TN. | en_US |
| Affilliation | Fundação Oswaldo Cruz. Instituto de Pesquisa Clínica Evandro Chagas. Rio de Janeiro, RJ, Brasil. | en_US |
| Affilliation | Fundação Oswaldo Cruz. Instituto de Pesquisa Clínica Evandro Chagas. Rio de Janeiro, RJ, Brasil. | en_US |
| Subject | Acute HIV Infection | en_US |
| Subject | Latent Tuberculosis Infection | en_US |
| Subject | Antiretroviral Therapy | en_US |
| Subject | Immune Reconstitution | en_US |
| Subject | Brazil | en_US |
| e-ISSN | 1944-7884 | |
