Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2023 Jul 28;12(8):990.
doi: 10.3390/pathogens12080990.

Latent Tuberculosis Infection and Associated Risk Factors among People Living with HIV and HIV-Uninfected Individuals in Lithuania

Elzbieta Matulyte  1 , Zavinta Kancauskiene  2 , Aidas Kausas  3 , Jurgita Urboniene  4 , Vilnele Lipnickiene  5 , Jelena Kopeykiniene  6 , Tomas Gudaitis  7 , Sarunas Raudonis  7 , Edvardas Danila  8   9 , Dominique Costagliola  10 , Raimonda Matulionyte  1
Affiliations

Latent Tuberculosis Infection and Associated Risk Factors among People Living with HIV and HIV-Uninfected Individuals in Lithuania

Elzbieta Matulyte et al. Pathogens. .

Abstract

Background: People living with HIV (PLHIV) with latent tuberculosis infection (LTBI) are at increased risk of tuberculosis (TB) reactivation compared to the HIV-negative population. Lithuania belongs to the 18 high-priority TB countries in the European region. The aim of this study was to compare the prevalence of LTBI and LTBI-related risk factors between PLHIV and HIV-uninfected populations.

Methods: A cross-sectional study was conducted in three Lithuanian Infectious Diseases centres from August 2018 to May 2022 using the interferon gamma release assay (IGRA) and tuberculin skin test (TST) in Vilnius, and IGRA only in Siauliai and Klaipeda. Cohen's kappa was used to assess IGRA and TST agreement. A structured questionnaire was completed by the study participants. LTBI-related risk factors were identified using a multivariable logistic regression model.

Results: In total, 391 PLHIV and 443 HIV-uninfected individuals enrolled, with a median age of 41 (IQR 36-48) and 43 (IQR 36-50), consisting of 69.8% and 65.5% male, respectively. The prevalence of LTBI defined by positive IGRA and/or TST among PLHIV was higher compared to that in the HIV-uninfected population (20.5% vs. 15.3%; OR 1.42; 95% CI 1.02-2.03; p = 0.04). The concordance between IGRA and TST was fair: kappa = 0.23 (95% CI 0.09-0.34). In multivariable analyses, association with injecting drug use (IDU) (ORa 2.25, 95% CI 1.27-3.99, p = 0.01) and imprisonment (ORa 1.99, 95% CI 1.13-3.52, p = 0.02) in all participants, IDU (ORa 2.37, 95% CI 1.09-5.15; p = 0.029) in PLHIV and a history of contact with an active TB patient (ORa 3.33, 95% CI 1.53-7.24; p = 0.002) in HIV-uninfected individuals were significant associations evidenced by LTBI.

Conclusions: The prevalence of LTBI among PLHIV in Lithuania is higher compared to that in the HIV-uninfected population and the European average. The association with IDU in PLHIV emphasizes the need for integrated HIV, TB and substance abuse treatment to provide patient-centred care.

Keywords: HIV; LTBI; TB; prevalence; risk factors.

PubMed Disclaimer

Conflict of interest statement

The authors declare that no competing interests exist.

Figures

Figure 1
Figure 1
Multivariable analysis of factors associated with LTBI among all study participants, PLHIV and HIV-uninfected individuals in Lithuania. LTBI: latent tuberculosis infection; PLHIV: people living with human immunodeficiency virus; CI: confidence interval; CD4: cluster differentiation-4; HIV: human immunodeficiency virus; TB: tuberculosis. Only variables with a p-value < 0.10 in either of the two univariable analyses of PLHIV and HIV-uninfected individuals were included in the multivariable analysis, except for hepatitis C because of its close association with intravenous drug use, and CD4 count, available only for PLHIV. The study population model includes 834 patients. The PLHIV model includes 363 patients, with 28 patients excluded due to missing data. The HIV-uninfected individual model includes 443 patients.
Figure 2
Figure 2
Flow chart showing the numbers of patients tested with TST and QFT-GIT in Vilnius University Hospital. PLHIV: people living with human immunodeficiency virus; HIV: human immunodeficiency virus; QFT-GIT: Quantiferon-TB Gold in-Tube; TST: tuberculin skin test.
See this image and copyright information in PMC

References

    1. WHO . Global Tuberculosis Report 2021. World Health Organization; Geneva, Switzerland: 2021.
    1. European Centre for Disease Prevention and Control/WHO Regional Office for Europe . HIV/AIDS Surveillance in Europe 2021–2020 Data. World Health Organization; Geneva, Switzerland: 2021.
    1. Kaef C., Benzon A., Panteleev A., Skrahina A., Bolokadze N., Tetradov S., Podlasin R., Karpov I., Borodulina E., Denisova E., et al. Delayed diagnosis of tuberculosis in persons living with HIV in Eastern Europe: Associated factors and effect on mortality—A multicentre prospective cohort study. BMC Infect. Dis. 2021;21:1038. - PMC - PubMed
    1. WHO . Latent Tuberculosis Infection: Updated and Consolidated Guidelines for Programmatic Management. World Health Organization; Geneva, Switzerland: 2018. Licence: CC BY-NC-SA 3.0 IGO. - PubMed
    1. Dye C., Scheele S., Dolin P., Pathania V., Raviglione M.C. Consensus statement. Global burden of tuberculosis: Estimated incidence, prevalence, and mortality by country. WHO Global Surveillance and Monitoring Project. J. Am. Med. Assoc. 1999;282:677–686. doi: 10.1001/jama.282.7.677. - DOI - PubMed

LinkOut - more resources