| Abstract [eng] |
Background. Latent tuberculosis infection (LTBI) is the most common form of the disease among patients infected with Mycobacterium tuberculosis (MTB). This study aimed to investigate the prevalence of LTBI and associated risk factors among human immunodeficiency virus (HIV)- infected and HIV-uninfected Lithuanian population. Methodology. The cross-sectional study included HIV-infected (HIV+) and HIVuninfected (HIV-) patients (control group) from Vilnius, Šiauliai and Klaipėda Infectious Disease Centres between 2018/08 and 2022/10. LTBI status was assessed by interferon-gamma release assay (IGRA). Concordance between IGRA and tuberculin test (TST) was fair: Cohen’s kappa=0.235 (95% Confidence interval (CI)=0.114–0.357). Univariate and multivariate regression models were used to identify risk factors associated with LTBI. Results. The prevalence of LTBI was higher in HIV+ patients than in HIV- patients, 17.0% and 11.1% (odds ratio (OR)=1.648; 95% confidence interval (CI)=1.117-2.447; p=0.012). The concordance between IGRA and tuberculin skin test (TST) was adequate: Cohen's kappa=0.235 (95% CI=0.114-0.357). Univariate logistic regression models showed that among HIV+ patients, the following factors were associated with LTBI: No tertiary education, initial CD4+ T lymphocyte count at HIV diagnosis >350/mm3, smoking, injection drug use (IDU), incarceration, hepatitis C virus (HCV) co-infection, unemployment, no fixed place of residence, presence of clinical symptoms of TB, receipt of substitution therapy with methadone, while among HIV- patients, the following factors were associated with LTBI: No tertiary education, IDU, incarceration, HCV coinfection, previous contact with an open TB patient. In the multivariable logistic regression model, the risk factor associated with LTBI among HIV+ patients remained IDU (OR=2.35; 95% CI=1.06-5.42; p=0.036), while among HIV- patients, the risk factor associated with LTBI remained previous contact with an open TB patient (OR=2.95; 95% CI=1.2-7.15; p=0.017). Conclusion. In summary, the study found a high prevalence of LTBI in Lithuania: 17.0% and 11.1% in HIV+ and HIV- populations, respectively. Risk factors associated with LTBI included: IDU in the HIV+ population and contact with an open TB patient in the HIV- population. These results defined the risk groups associated with LTBI in Lithuania and the importance of the development and implementation of a programme for the management of latent tuberculosis infection (preventive diagnostic testing and preventive treatment). |
