{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,30]],"date-time":"2026-04-30T02:51:53Z","timestamp":1777517513675,"version":"3.51.4"},"reference-count":27,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2018,2,21]],"date-time":"2018-02-21T00:00:00Z","timestamp":1519171200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["HIV Medicine"],"published-print":{"date-parts":[[2018,5]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>A high prevalence of tuberculosis (<jats:styled-content style=\"fixed-case\">TB<\/jats:styled-content>) among <jats:styled-content style=\"fixed-case\">HIV<\/jats:styled-content>\u2010positive injecting drug users (<jats:styled-content style=\"fixed-case\">IDU<\/jats:styled-content>s) may fuel the <jats:styled-content style=\"fixed-case\">TB<\/jats:styled-content> epidemic in the general population of Romania. We determined the frequency and characteristics of <jats:styled-content style=\"fixed-case\">TB<\/jats:styled-content> in <jats:styled-content style=\"fixed-case\">HIV<\/jats:styled-content>\u2010infected <jats:styled-content style=\"fixed-case\">IDU<\/jats:styled-content>s referred to a national centre.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Prospective observational cohort study of all newly\u2010diagnosed <jats:styled-content style=\"fixed-case\">HIV<\/jats:styled-content>\u2010positive <jats:styled-content style=\"fixed-case\">IDU<\/jats:styled-content>s admitted to Victor Babes Hospital, Bucharest, between January 2009 and December 2014. Socio\u2010demographics, clinical characteristics and outcomes of <jats:styled-content style=\"fixed-case\">HIV<\/jats:styled-content>\/<jats:styled-content style=\"fixed-case\">TB<\/jats:styled-content> co\u2010infected <jats:styled-content style=\"fixed-case\">IDU<\/jats:styled-content>s were compared to <jats:styled-content style=\"fixed-case\">HIV<\/jats:styled-content>\u2010positive <jats:styled-content style=\"fixed-case\">IDU<\/jats:styled-content>s without <jats:styled-content style=\"fixed-case\">TB<\/jats:styled-content>.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>170\/598 (28.5%) <jats:styled-content style=\"fixed-case\">HIV<\/jats:styled-content>\u2010infected <jats:styled-content style=\"fixed-case\">IDU<\/jats:styled-content>s were diagnosed with <jats:styled-content style=\"fixed-case\">TB<\/jats:styled-content>. The prevalence increased from 12.5% in 2009 to 32.1% in 2014 (<jats:italic>P<\/jats:italic> &lt; 0.001). <jats:styled-content style=\"fixed-case\">HIV<\/jats:styled-content>\/<jats:styled-content style=\"fixed-case\">TB<\/jats:styled-content> co\u2010infected individuals had lower median <jats:styled-content style=\"fixed-case\">CD<\/jats:styled-content>4 cell counts 75 (<jats:italic>vs<\/jats:italic>. 450\/mm<jats:sup>3<\/jats:sup>, <jats:italic>P<\/jats:italic> &lt; 0.0001) and higher median <jats:styled-content style=\"fixed-case\">HIV<\/jats:styled-content> viral loads 5.6 log<jats:sub>10<\/jats:sub> (<jats:italic>vs<\/jats:italic>. 4.9 log<jats:sub>10<\/jats:sub>, <jats:italic>P<\/jats:italic> &lt; 0.0001) when presenting to healthcare services. 103\/170 (60.6%) <jats:styled-content style=\"fixed-case\">HIV<\/jats:styled-content>\/<jats:styled-content style=\"fixed-case\">TB<\/jats:styled-content> co\u2010infected <jats:styled-content style=\"fixed-case\">IDU<\/jats:styled-content>s were diagnosed with pulmonary <jats:styled-content style=\"fixed-case\">TB<\/jats:styled-content>. Resistant <jats:italic>Mycobacterium tuberculosis<\/jats:italic> strains were common, with 18\/105 (17.1%) of patients having Multi\u2010Drug Resistant (<jats:styled-content style=\"fixed-case\">MDR<\/jats:styled-content>) disease. Higher mortality rate was associated with <jats:styled-content style=\"fixed-case\">TB<\/jats:styled-content> co\u2010infection (<jats:italic>P<\/jats:italic> &lt; 0.0001), extra\u2010pulmonary <jats:styled-content style=\"fixed-case\">TB<\/jats:styled-content> (<jats:italic>P<\/jats:italic> = 0.0026) and extensively drug resistant <jats:styled-content style=\"fixed-case\">TB<\/jats:styled-content> (<jats:italic>P<\/jats:italic> = 0.024).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Tuberculosis (<jats:styled-content style=\"fixed-case\">TB<\/jats:styled-content>) is an increasing problem in <jats:styled-content style=\"fixed-case\">HIV<\/jats:styled-content>\u2010infected <jats:styled-content style=\"fixed-case\">IDU<\/jats:styled-content>s in Romania. Presentation is often with advanced <jats:styled-content style=\"fixed-case\">HIV<\/jats:styled-content>, significant <jats:styled-content style=\"fixed-case\">TB<\/jats:styled-content> drug resistance and consequent outcomes are poor.<\/jats:p><\/jats:sec>","DOI":"10.1111\/hiv.12576","type":"journal-article","created":{"date-parts":[[2018,2,21]],"date-time":"2018-02-21T20:22:53Z","timestamp":1519244573000},"page":"316-323","source":"Crossref","is-referenced-by-count":6,"title":["Increasing incidence of HIV\u2010 associated tuberculosis in Romanian injecting drug users"],"prefix":"10.1111","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9581-2527","authenticated-orcid":false,"given":"C","family":"Oprea","sequence":"first","affiliation":[{"name":"Carol Davila University of Medicine and Pharmacy Bucharest Romania"},{"name":"Victor Babes Clinical Hospital for Infectious and Tropical Diseases Bucharest Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"I","family":"Ianache","sequence":"additional","affiliation":[{"name":"Victor Babes Clinical Hospital for Infectious and Tropical Diseases Bucharest Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"PI","family":"Calistru","sequence":"additional","affiliation":[{"name":"Carol Davila University of Medicine and Pharmacy Bucharest Romania"},{"name":"Victor Babes Clinical Hospital for Infectious and Tropical Diseases Bucharest Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M","family":"Nica","sequence":"additional","affiliation":[{"name":"Carol Davila University of Medicine and Pharmacy Bucharest Romania"},{"name":"Laboratory of Bacteriology Victor Babes Clinical Hospital for Infectious and Tropical Diseases Bucharest Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"S","family":"Ruta","sequence":"additional","affiliation":[{"name":"Carol Davila University of Medicine and Pharmacy Bucharest Romania"},{"name":"Stefan S. Nicolau Institute of Virology Bucharest Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"C","family":"Smith","sequence":"additional","affiliation":[{"name":"Institute of Global Health University College London London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M","family":"Lipman","sequence":"additional","affiliation":[{"name":"Royal Free London NHS Foundation Trust London UK"},{"name":"UCL Respiratory Division of Medicine University College London London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2018,2,21]]},"reference":[{"key":"#cr-split#-e_1_2_7_2_1.1","unstructured":"WHO.Plan to stop TB in 18 High\u2010priority Countries in the European Region 2007-20152007[updated 2007"},{"key":"#cr-split#-e_1_2_7_2_1.2","unstructured":"cited July 2017]. Available at:http:\/\/www.euro.who.int\/__data\/assets\/pdf_file\/0005\/68180\/E91049.pdf."},{"key":"e_1_2_7_3_1","unstructured":"ECDC WHO.Tuberculosis surveillance and monitoring in Europe 2017 Stockholm:: European Centre for Disease Prevention and Control;2017[updated 2017; cited 2017]. Available at:https:\/\/ecdc.europa.eu\/sites\/portal\/files\/media\/en\/publications\/Publications\/ecdc-tuberculosis-surveillance-monitoring-Europe-2017.pdf."},{"key":"e_1_2_7_4_1","unstructured":"EMCDDA.Romania New Developments Trends and In\u2010depth Information on Selected Issues; European Monitoring Centre for National (EMCDDA); Anti\u2010drug Agency Drugs and Drug Addiction2011[updated 2012; cited July 2012]. Available at:http:\/\/www.ana.gov.ro\/rapoarte%20nationale\/en\/National%20Report%20on%20Drugs%202011.pdf."},{"key":"e_1_2_7_5_1","unstructured":"ACMD.Consideration of the cathinones Advisory Council on the Misuse of Drugs Home Office London2010[updated 2010; cited 2017 July]. Available at:http:\/\/www.homeoffice.gov.uk\/publications\/drugs\/acmd1\/acmd-cathinodes-report-2010."},{"issue":"1","key":"e_1_2_7_6_1","first-page":"189","article-title":"The main characteristics of the Romanian illegal drug markets","volume":"3","author":"Maftei L","year":"2012","journal-title":"Eastern J Eur Stud"},{"key":"e_1_2_7_7_1","unstructured":"EMCDDA Anti\u2010Drog AN.National Report to the European Monitoring Centre for National (EMCDDA) Romania 2014[Raport National privind Situatia Drogurilor 2014 Romania; Noi evolu\u0163ii \u015fi tendin\u0163e]2014[cited 2014]. Available at:http:\/\/www.ana.gov.ro\/rapoarte%20nationale\/RO_RN_2014.pdf."},{"key":"e_1_2_7_8_1","unstructured":"BotescuA.Risk assessment of new psychoactive substances consumption among children and youth in Romania. Network RHR; 20122012."},{"key":"e_1_2_7_9_1","unstructured":"CNLAS.The evolution of HIV\/AIDS in Romania 31 December 2014;2014[updated July 2014]. Available at:http:\/\/www.cnlas.ro\/images\/doc\/31122014_rom.pdf."},{"key":"e_1_2_7_10_1","unstructured":"CNLAS.Specific Challenges of the HIV Epidemic in Romania 2013;2013[updated 2013; cited 2017 July]. Available at:http:\/\/www.cnlas.ro\/images\/doc\/spec_chall_HIV.pdf."},{"key":"e_1_2_7_11_1","unstructured":"EMCDDA.Raportul national privind situatia drogurilor 2013; Romania; Noi evolutii tendinte si informatii detaliate cu privier la temele de interes European2013[updated 2013; cited 2013 Decembre]. Available at:http:\/\/www.ana.gov.ro\/rapoarte%20nationale\/RN_2013.pdf."},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.puhe.2013.08.018"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.3851\/IMP1522"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1468-1293.2010.00857.x"},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.1086\/651495"},{"key":"e_1_2_7_16_1","doi-asserted-by":"publisher","DOI":"10.1136\/thoraxjnl-2014-206452"},{"key":"e_1_2_7_17_1","doi-asserted-by":"publisher","DOI":"10.1155\/2012\/931325"},{"key":"e_1_2_7_18_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0063916"},{"key":"e_1_2_7_19_1","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2334-14-148"},{"key":"e_1_2_7_20_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12981-016-0106-y"},{"key":"e_1_2_7_21_1","doi-asserted-by":"publisher","DOI":"10.3201\/eid1409.070654"},{"key":"e_1_2_7_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugpo.2013.10.002"},{"key":"e_1_2_7_23_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0078941"},{"key":"e_1_2_7_24_1","doi-asserted-by":"publisher","DOI":"10.5588\/ijtld.12.0703"},{"key":"e_1_2_7_25_1","unstructured":"WHO.Integrating collaborative TB and HIV services within a comprehensive package of care for people who inject drugs \u2010 WHO Consolidated guidelines Geneva2016[updated 2016; cited 2017 July]. Available at:http:\/\/apps.who.int\/iris\/bitstream\/10665\/204484\/1\/9789241510226_eng.pdf?ua=1."},{"key":"e_1_2_7_26_1","doi-asserted-by":"publisher","DOI":"10.1097\/QAD.0b013e3283326879"},{"key":"e_1_2_7_27_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2352-3018(15)00252-0"}],"container-title":["HIV Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fhiv.12576","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/hiv.12576","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/hiv.12576","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/hiv.12576","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,10]],"date-time":"2023-09-10T14:06:58Z","timestamp":1694354818000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/hiv.12576"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,2,21]]},"references-count":27,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2018,5]]}},"alternative-id":["10.1111\/hiv.12576"],"URL":"https:\/\/doi.org\/10.1111\/hiv.12576","archive":["Portico"],"relation":{},"ISSN":["1464-2662","1468-1293"],"issn-type":[{"value":"1464-2662","type":"print"},{"value":"1468-1293","type":"electronic"}],"subject":[],"published":{"date-parts":[[2018,2,21]]}}}