Association of HIV and Mtb infection among household contacts in East and Southern Africa

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BACKGROUND Understanding the association of HIV and antiretroviral therapy (ART) status with Mycobacterium tuberculosis ( Mtb ) transmission dynamics is crucial, particularly in the context of universal ART access. METHODS This cross-sectional analysis included adults with microbiologically confirmed pulmonary TB (medium/high Xpert MTB/Rif) and their household contacts (≥10 years) from Mozambique, Zimbabwe, and Tanzania (2021–2023). Mixed-effects logistic regression assessed associations between TB patients’ HIV/ART status and household interferon-gamma release assay (IGRA) positivity. RESULTS A total of 1,923 household contacts of 907 persons with TB were analysed. A third of persons with TB were diagnosed with HIV at the time of TB diagnosis. Overall, 46% of household contacts were IGRA positive at baseline. Household contacts exposed to ART-treated people living with HIV (PLHIV) exhibited high IGRA positivity levels compared with those exposed to PLHIV not on ART (adjusted odds ratio [aOR] 1.88; 95% confidence interval [CI]: 1.17–3.02). Odds for contacts of ART-treated PLHIV was similar to the odds observed in contacts of HIV-negative individuals (aOR 2.21; 95% CI: 1.45–3.36). DISCUSSION In a selected population of people with TB with a medium to high bacillary burden measured by Xpert MTB/Rif, PLHIV while on ART exhibited increased Mtb transmission, comparable with the levels of HIV uninfected.

Ce résumé expose les affirmations des auteurs. BNTIC ne l’interprète pas comme une validation indépendante des résultats.