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Tuberculosis after initiation of antiretroviral therapy in low-income and high-income countries.

, , Brinkhof MW, Egger M, Boulle A, May M, Hosseinipour M, Sprinz E, Braitstein P, Dabis F, Reiss P, Bangsberg DR, Rickenbach M, Miro JM, Myer L, Mocroft A, Nash D, Keiser O, Pascoe M, van der Borght S, Schechter M

Institute of Social and Preventive Medicine (ISPM), University of Berne, Finkenhubelweg 11, CH-3012 Bern, Switzerland.

We examined the incidence of and risk factors for tuberculosis during the first year of highly active antiretroviral therapy in low-income (4540 patients) and high-income (22,217 patients) countries. Although incidence was much higher in low-income countries, the reduction in the incidence of tuberculosis associated with highly active antiretroviral therapy was similar: the rate ratio for months 7-12 versus months 1-3 was 0.48 (95% confidence interval, 0.36-0.64) in low-income countries and 0.36 (95% confidence interval, 0.26-0.50) in high-income countries. A low CD4 cell count at the start of therapy was the most important risk factor in both settings.

Published 8 November 2007 in Clin Infect Dis, 45(11): 1518-21.
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