Open AccessActive and latent tuberculosis among HIV‐positive injecting drug users in Indonesia
Author(s) -
Meijerink Hinta,
Wisaksana Rudi,
Lestari Mery,
Meilana Intan,
Chaidir Lydia,
Ven Andre JAM,
Alisjahbana Bachti,
Crevel Reinout
Publication year - 2015
Publication title -
journal of the international aids society
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.724
H-Index - 62
ISSN - 1758-2652
DOI - 10.7448/ias.18.1.19317
Subject(s) - medicine , tuberculosis , latent tuberculosis , history of tuberculosis , isoniazid , active tuberculosis , human immunodeficiency virus (hiv) , drug , immunology , mycobacterium tuberculosis , pharmacology , pathology
Injecting drug use (IDU) is associated with tuberculosis but few data are available from low‐income settings. We examined IDU in relation to active and latent tuberculosis (LTBI) among HIV‐positive individuals in Indonesia, which has a high burden of tuberculosis and a rapidly growing HIV epidemic strongly driven by IDU. Methods Active tuberculosis was measured prospectively among 1900 consecutive antiretroviral treatment (ART)‐naïve adult patients entering care in a clinic in West Java. Prevalence of LTBI was determined cross‐sectionally in a subset of 518 ART‐experienced patients using an interferon‐gamma release assay. Results Patients with a history of IDU (53.1%) more often reported a history of tuberculosis treatment (34.8% vs. 21.9%, p <0.001), more often received tuberculosis treatment during follow‐up (adjusted HR=1.71; 95% CI: 1.25–2.35) and more often had bacteriologically confirmed tuberculosis (OR=1.67; 95% CI: 0.94–2.96). LTBI was equally prevalent among people with and without a history of IDU (29.1 vs. 30.4%, NS). The risk estimates did not change after adjustment for CD4 cell count or ART. Conclusions HIV‐positive individuals with a history of IDU in Indonesia have more active tuberculosis, with similar rates of LTBI. Within the HIV clinic, LTBI screening and isoniazid preventive therapy may be prioritized to patients with a history of IDU.