Positive rate and risk factors of latent tuberculosis infection among persons living with HIV in Jiangsu Province, China

Yu Zhang; Peng Lu; Kai Wu; Hongxi Zhou; Haibing Yu; Ju Yuan; Lang Dong; Qiao Liu; Wei Lu; Haitao Yang; Dianyi Cao; Limei Zhu

doi:10.3389/fcimb.2023.1051060

Positive rate and risk factors of latent tuberculosis infection among persons living with HIV in Jiangsu Province, China

Front Cell Infect Microbiol. 2023 Mar 7:13:1051060. doi: 10.3389/fcimb.2023.1051060. eCollection 2023.

Authors

Yu Zhang^{1

2}, Peng Lu¹, Kai Wu³, Hongxi Zhou³, Haibing Yu³, Ju Yuan³, Lang Dong³, Qiao Liu¹, Wei Lu¹, Haitao Yang^{2

4}, Dianyi Cao³, Limei Zhu¹

Affiliations

¹ Department of Chronic Communicable Disease, Center for Disease Control and Prevention of Jiangsu Province, Nanjing, Jiangsu, China.
² School of Public Health, Southeast University, Nanjing, Jiangsu, China.
³ Jiangsu Prison Administration, Central Hospital, Changzhou, Jiangsu, China.
⁴ Health Policy Research Department, Jiangsu Provincial Health Development Research Center, Jiangsu, China.

Abstract

Objective: To analyze the latent tuberculosis infection (LTBI) among persons living with HIV(PLWH) in Jiangsu Province, to explore the factors affecting the positive rate of LTBI, and to take appropriate measures to control tuberculosis (TB) infection.

Methods: A cross-sectional study was conducted among PLWH in Jiangsu Province from June to July 2021. All PLWH in Jiangsu Province were used as the study population. Currently, the diagnosis of LTBI lacks a "gold standard" and can only be assisted by the immunological method. In this study, Tuberculin skin test (TST), ESAT6-CFP10 test (EC), and QuantiFERON-TB gold in-tube (QFT) were used to detect the positive rate of LTBI among PLWH and to analyze their risk factors.

Results: A total of 340 prisoners were included, 89.7% were male, the median age was 38 years [Interquartile Range (IQR):32-46 years], these patients were on Antiviral Therapy (ART), and median CD4 counts was 376 (IQR: 261-496), 103 (30.3%) were positive in at least one test, LTBI by TST was 16.5%, LTBI by EC was 15.9%, LTBI by QFT was 26.2%. Univariate analysis showed the results for TST, EC, and QFT were not affected by CD4 counts (p>0.05), and multivariate analysis showed that a history of incarceration was associated with an increased risk of positive TST (adjusted odds ratio [aOR]=1.98;95% CI,1.03-3.82), EC (aOR=2.65;95% CI,1.37-5.12) and QFT (aOR=2.01;95%CI,1.12-3.57), in addition, female gender was associated with increased risk of positive TST (aOR=3.66;95%CI,1.60-8.37) and EC (aOR=3.43;95%CI,1.46-8.07), and contact history of TB patients was associated with increased risk of TST (aOR= 2.54;95%CI,1.23-5.22) and QFT (aOR=2.03;95%CI,1.03-3.99), and ethnic minorities (aOR=0.26;95%CI,0.12-0.57), longer duration of incarceration was associated with an increased risk of positive QFT (aOR=1.12;95%CI,1.02-1.24). Conclusions Female gender, and ethnic minorities, history of incarceration, longer duration of incarceration, and contact history of TB patients are risk factors for LTBI among PLWH in Jiangsu Province, and attention should be paid to TB control in this population.

Keywords: HIV; latent tuberculosis infection; positive rate; prison; risk factors.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Adult
China / epidemiology
Cross-Sectional Studies
Female
HIV Infections* / complications
HIV Infections* / epidemiology
Humans
Interferon-gamma Release Tests / methods
Latent Tuberculosis* / diagnosis
Latent Tuberculosis* / epidemiology
Male
Risk Factors
Tuberculosis* / complications
Tuberculosis* / diagnosis
Tuberculosis* / epidemiology

Grants and funding

The work was supported by “Key scientific research project of Jiangsu Commission Health” [grant numbers: ZD2021052]; “Key scientific research project of Jiangsu Commission Health” [grant numbers: ZDA2020022].