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Does antiretroviral treatment increase the infectiousness of smear-positive pulmonary tuberculosis?

Does antiretroviral treatment increase the infectiousness of smear-positive pulmonary tuberculosis?
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Khan PY, Crampin AC, Mzembe T, Koole O, Fielding KL, Kranzer K, Glynn JR,


Khan PY, Crampin AC, Mzembe T, Koole O, Fielding KL, Kranzer K, Glynn JR, (click to view)

Khan PY, Crampin AC, Mzembe T, Koole O, Fielding KL, Kranzer K, Glynn JR,

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The international journal of tuberculosis and lung disease : the official journal of the International Union against Tuberculosis and Lung Disease 21(11) 1147-1154 doi 10.5588/ijtld.17.0162

Abstract
BACKGROUND
Understanding of the effects of human immunodeficiency virus (HIV) infection and antiretroviral treatment (ART) on Mycobacterium tuberculosis transmission dynamics remains limited. We undertook a cross-sectional study among household contacts of smear-positive pulmonary tuberculosis (TB) cases to assess the effect of established ART on the infectiousness of TB.

METHOD
Prevalence of tuberculin skin test (TST) positivity was compared between contacts of index cases aged 2-10 years who were HIV-negative, HIV-positive but not on ART, on ART for <1 year and on ART for 1 year. Random-effects logistic regression was used to take into account clustering within households. RESULTS
Prevalence of M. tuberculosis infection in contacts of HIV-negative patients, HIV-positive patients on ART 1 year and HIV-positive patients not on ART/on ART <1 year index cases was respectively 44%, 21% and 22%. Compared to contacts of HIV-positive index cases not on ART or recently started on ART, the odds of TST positivity was similar in contacts of HIV-positive index cases on ART 1 year (adjusted OR [aOR] 1.0, 95%CI 0.3-3.7). The odds were 2.9 times higher in child contacts of HIV-negative index cases (aOR 2.9, 95%CI 1.0-8.2). CONCLUSIONS
We found no evidence that established ART increased the infectiousness of smear-positive, HIV-positive index cases.

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