| Abstract [eng] |
Tuberculosis remains one of the most important infectious diseases worldwide and continues to be a significant public health problem in Lithuania. Although the main focus is placed on the diagnosis and treatment of active tuberculosis, long-term control of this disease is not possible without the identification and management of latent tuberculosis infection. Latent tuberculosis infection serves as a reservoir from which active disease may later develop, particularly in the presence of risk factors. This issue is especially important among people living with human immunodeficiency virus, as they have a higher risk of progression from latent tuberculosis infection to active disease. For this reason, assessing the prevalence of latent tuberculosis infection and its associated risk factors is important from both epidemiological and practical perspectives. In Lithuania data on the prevalence of latent tuberculosis infection among people with and without human immunodeficiency virus infection, as well as on the risk factors distinguishing these groups, remain insufficient. Aim of the study. To evaluate the prevalence of latent tuberculosis infection and its associated risk factors in the population infected with human immunodeficiency virus. Objectives of the study: 1. To assess and compare the prevalence of latent tuberculosis infection among populations with and without human immunodeficiency virus infection. 2. To determine the risk of latent tuberculosis infection in the group of individuals infected with human immunodeficiency virus and to evaluate the factors associated with it. 3. To identify the factors associated with the risk of latent tuberculosis infection in the group of individuals without human immunodeficiency virus infection. Methods. A cross-sectional study was conducted. From March 2023 to March 2026, data were collected from six hospitals in Lithuania. A total of 2,875 patients were included in the final analysis; of whom 312 were infected with human immunodeficiency virus and 2,563 were uninfected. Latent tuberculosis infection was defined by a positive interferon-gamma release assay and/or tuberculin skin test. Demographic, social, behavioral, and clinical factors were assessed. Statistical analysis was performed using univariate and multivariate logistic regression. Results and conclusions. The prevalence of latent tuberculosis infection was 10.9% among individuals infected with human immunodeficiency virus and 12.3% among uninfected individuals; no statistically significant difference was found between the groups. In the group infected with human immunodeficiency virus the only independent risk factor for latent tuberculosis infection was a CD4+ T-cell count of ≤350 cells/mm³. In the group uninfected with human immunodeficiency virus infection, latent tuberculosis infection was independently associated with older age, no higher education, harmful alcohol use, history of imprisonment, injection drug use, and detected anti-HCV antibodies. In the human immunodeficiency virus infected group living with more than three people is associated with a lower risk of latent tuberculosis infection. Independent risk factors in the overall sample were similar to those observed in the human immunodeficiency virus uninfected group. In the overall sample the risk of latent tuberculosis infection is increased by male gender, older age, injecting drug use, previous imprisonment in a prison, lack of higher education, harmful alcohol use and detected anti-HCV antibodies. These findings indicate that the prevalence of latent tuberculosis infection did not differ significantly between individuals with and without human immunodeficiency virus infection; however, the structure of risk factors differed between the groups. The risk of latent tuberculosis infection is determined by both clinical and social factors; therefore, screening should be based on individual risk assessment and targeted toward high-risk groups. |
