期刊
AIDS
卷 24, 期 5, 页码 763-771出版社
LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1097/QAD.0b013e3283366747
关键词
epidemiology; HIV/AIDS; immigration; industrialized country; tuberculosis
资金
- Institut National de la Sante et de la Recherche Medicale (INSERM)
- Agence Nationale de la Recherche sur le SIDA (ANRS)
- French Ministry of Health
Objective: To examine trends in tuberculosis incidence rates in France during the combination antiretroviral therapy (cART) period. Methods: From the French Hospital Database on HIV, we selected 72 580 patients (including 14 491 migrants) with no history of tuberculosis, followed between 1 January 1997 and 31 December 2008. We then examined incidence rates of tuberculosis and its risk factors. Results: A total of 2625 patients were diagnosed with tuberculosis either at enrolment (N = 932) or during follow-up (N = 1693). During follow-up, the incidence rate of tuberculosis was 0.40/100 patient-years overall, 0.20 among nonmigrants and 1.03 among migrants. Adjusted risk of tuberculosis was 2.01 [95% confidence interval (CI) 1.79-2.26] times higher in migrants than in nonmigrants. The adjusted incidence rate of tuberculosis significantly increased in both migrants and nonmigrants after 2000-2001, with adjusted risks of 2.50 (95% CI 1.54-4.06) and 1.85 (95% CI 1.27-2.69) in 2008 compared with that in 1997, respectively. Other factors independently associated with a higher incidence of tuberculosis were medical follow-up less than or equal to 6 months, no previous antiretroviral therapy, lower CD4 cell count and higher viral load. Nonmigrant patients belonging to HIV-transmission groups other than homosexual men, residing in the Paris area or in French West Indies or with AIDS status were at a supplementary risk. Conclusion: The incidence of tuberculosis is increasing among both migrant and nonmigrant HIV-infected patients in France. This is partly because sub-Saharan African migrants represent an increasing fraction of the HIV-infected population in France and also because of late access to care. Co-prescribing tuberculosis preventive therapy with cART might benefit selected patients, such as migrants and patients with late access to care. (C) 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins
作者
我是这篇论文的作者
点击您的名字以认领此论文并将其添加到您的个人资料中。
推荐
暂无数据