Tuberculosis (TB) remains an important public health problem, particularly among people infected with the human immunodeficiency virus (HIV).
It has been observed that the risk of TB is increased in the six months following initiation of highly active antiretroviral therapy (HAART) for HIV. To formally evaluate this risk, April Pettit, M.D., MPH, Timothy Sterling, M.D., and colleagues studied more than 26,000 HIV-infected adults enrolled in a U.S.-Canadian cohort between 1998 and 2011.
After adjusting for the “load” of HIV (amount of virus in the bloodstream) and CD4+ count (number of white blood cells targeted by the virus), the researchers found that TB risk in the first six months after HAART initiation was no higher than it was in the six months prior. The findings, which were published this summer in the Journal of Acquired Immunodeficiency Deficiency Syndrome, support early initiation of HAART to decrease TB risk, perhaps as part of a “test-and-treat” strategy for HIV infection.
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