Sex differences in tuberculosis infection and disease among people with HIV.

IF 3.4 2区医学 Q3 IMMUNOLOGY

AIDS Pub Date : 2025-02-01 Epub Date: 2024-10-24 DOI:10.1097/QAD.0000000000004045

Lelia H Chaisson, Betina Durovni, Nasir Umar, Silvia Cohn, Lawrence H Moulton, Eileen Scully, Solange Cavalcante, Jonathan E Golub, Richard E Chaisson, Valeria Saraceni

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Abstract

Objectives: Worldwide, adult men experience an excess burden of tuberculosis (TB) disease compared with women, but few studies have examined sex differences in TB among people with HIV. In this study, we aimed to investigate sex differences in TB infection and disease among people with HIV in Rio de Janeiro, Brazil.

Design: Analysis of data from a randomized controlled trial and retrospective cohort study.

Methods: We analyzed data from two studies conducted between 2005 and 2017. The THRio Study (2005-2012) evaluated increasing tuberculin skin testing (TST) and TB preventive therapy (TPT), and Universal ART in Rio study (UnivART; 2010-2017) was a virtual cohort study of people with HIV and TB with data from four national electronic registries.

Results: Among 4606 people with HIV in THRio, 2992 (65.0%) had a TST placed and read, of whom 312 of 1865 (17%) males and 203 of 1127 (18%) females ( P = 0.37) had prevalent TB infection. TB disease incidence was higher among males compared with females overall [IRR 1.33, 95% confidence interval (95% CI) 1.04-1.69], among males compared with females who did not receive TPT [incidence rate ratios (IRR) 1.30, 95% CI 1.01-1.67], and among males compared with females on ART (IRR 1.64, 95% CI 1.17-2.29). Among 54 957 people with HIV in UnivART, TB disease incidence rates were higher among males than females overall (IRR 1.28, 95% CI 1.18-1.39), among males compared with females on ART (IRR 1.58, 95% CI 1.40-1.77), and among males compared with females not on ART (IRR 1.11, 95% CI 0.99-1.25).

Conclusion: In this medium TB and HIV burden setting, TB disease incidence was higher among males than females with HIV, despite similar prevalence of TB infection.

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艾滋病毒感染者中结核病感染和发病的性别差异。

研究目的在世界范围内，成年男性的结核病负担比女性要重，但很少有研究对艾滋病病毒感染者中结核病的性别差异进行调查。在这项研究中，我们旨在调查巴西里约热内卢 HIV 感染者中结核病感染和发病的性别差异：设计：分析随机对照试验和回顾性队列研究的数据：我们分析了 2005 年至 2017 年间开展的两项研究的数据。THRio研究（2005-2012年）评估了结核菌素皮试（TST）和结核病预防疗法（TPT）的增加情况，UnivART研究（2010-2017年）是一项针对艾滋病病毒感染者和结核病患者的虚拟队列研究，数据来自四个国家电子登记处：在 THRio 的 4,606 名艾滋病病毒感染者中，2,992 人（65.0%）进行了 TST 检测并读取了结果，其中 312/1,865 名男性（17%）和 203/1,127 名女性（18%）（p = 0.37）感染了流行性结核病。总体而言，男性结核病发病率高于女性（IRR 为 1.33，95% CI 为 1.04-1.69），男性结核病发病率高于未接受 TPT 的女性（IRR 为 1.30，95% CI 为 1.01-1.67），男性结核病发病率高于接受抗逆转录病毒疗法的女性（IRR 为 1.64，95% CI 为 1.17-2.29）。在 UnivART 的 54957 名艾滋病病毒感染者中，男性结核病发病率总体上高于女性（IRR 为 1.28，95% CI 为 1.18-1.39），男性结核病发病率高于接受抗逆转录病毒疗法的女性（IRR 为 1.58，95% CI 为 1.40-1.77），男性结核病发病率高于未接受抗逆转录病毒疗法的女性（IRR 为 1.11，95% CI 为 0.99-1.25）：结论：在这一结核病和艾滋病负担中等的环境中，尽管结核病感染率相似，但男性艾滋病感染者的结核病发病率高于女性艾滋病感染者。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

AIDS 医学-病毒学

CiteScore

5.90

自引率

5.30%

发文量

478

审稿时长

3 months

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