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. 2016 Nov 28;30(18):2845-2853.
doi: 10.1097/QAD.0000000000001252.

Tuberculosis and HIV coinfection in Europe: looking at one reality from two angles

Marieke J van der Werf  1 , Csaba Ködmön, Phillip Zucs, Vahur Hollo, Andrew J Amato-Gauci, Anastasia Pharris
Affiliations

Tuberculosis and HIV coinfection in Europe: looking at one reality from two angles

Marieke J van der Werf et al. AIDS. .

Abstract

Objective: To better understand the epidemiology of tuberculosis (TB)/HIV coinfection in the European Union (EU) and European Economic Area (EEA) for planning of prevention and control measures.

Design: Analysis of surveillance data.

Methods: We performed an analysis of the 2014 TB and AIDS data to assess the burden of TB/HIV coinfection and we applied multivariable logistic regression to evaluate predictors for coinfection.

Results: Twenty-one of 31 EU/EEA countries reported HIV testing results for 64.6% of the 32 892 notified TB cases. Of those, 1051 (4.9%) were reported as HIV-positive. Males [adjusted odds ratio (aOR) 1.25; 95% confidence interval (CI) 1.07-1.46] and those in age group 25-44 years were more frequently coinfected. TB cases originating from the WHO African region had the highest proportion of coinfection (aOR 3.28 versus origin in EU/EEA; 95% CI 2.35-4.57). TB treatment was completed successfully by 57.9% of HIV-positive TB cases and 83.5% of HIV-negative cases. In 2014, 3863 cases of AIDS were reported by 29 EU/EEA countries; 691 (17.9%) of these cases presented with TB as an AIDS-defining illness. Persons who had acquired HIV through injecting drug use had higher odds of TB as an AIDS-defining illness (aOR 1.78 versus heterosexual route of transmission; 95% CI 1.37-2.32).

Conclusion: TB/HIV coinfection is a substantial problem in the EU/EEA. The occurrence of TB in HIV-positive cases and the low TB treatment success rate suggest that international guidelines for prevention and treatment of TB in HIV-infected adults need to be better implemented.

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Figures

Fig. 1
Fig. 1
Percentage of HIV-positive cases among tuberculosis cases with known HIV status, by country, European Union and European Economic Area, 2014.
Fig. 2
Fig. 2
Percentage of AIDS diagnoses with tuberculosis reported as AIDS-defining illness, by country, European Union and European Economic Area, 2014.
See this image and copyright information in PMC

References

    1. UNAIDS. How AIDS changed everything – MDG6: 15 years, 15 lessons of hope from the AIDS response. Geneva: UNAIDS; 2015.
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    1. European Centre for Disease Prevention and Control, World Health Organization Regional Office for Europe. HIV/AIDS surveillance in Europe 2014. Stockholm: European Centre for Disease Prevention and Control; 2015.
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