{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T17:24:18Z","timestamp":1782840258536,"version":"3.54.5"},"reference-count":67,"publisher":"BMJ","issue":"1","license":[{"start":{"date-parts":[[2023,5,17]],"date-time":"2023-05-17T00:00:00Z","timestamp":1684281600000},"content-version":"unspecified","delay-in-days":16,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open Resp Res"],"accepted":{"date-parts":[[2023,4,28]]},"published-print":{"date-parts":[[2023,5]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Tuberculosis (TB) disease is the leading cause of mortality among people living with HIV (PLHIV). Interferon-gamma release assays (IGRAs) are approved for TB infection ascertainment. However, current IGRA data on the prevalence of TB infection in the context of near-universal access to antiretroviral therapy (ART) and TB preventive therapy (TPT) are lacking. We estimated the prevalence and determinants of TB infection among PLHIV within a high TB and HIV burden context.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This cross-sectional study included data from adult PLHIV age \u226518 years in whom QuantiFERON-TB Gold Plus (QFT-Plus) assay, an IGRA, was performed. TB infection was defined as a positive or indeterminate QFT-Plus test. Participants with TB and those who had previously used TPT were excluded. Regression analysis was performed to identify independent predictors of TB infection.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Of 121 PLHIV with QFT-Plus test results, females were 74.4% (90\/121), and the mean age was 38.4 (SD 10.8) years. Overall, 47.9% (58\/121) were classified as TB infection (QFT-Plus test positive and indeterminate results were 39.7% (48\/121) and 8.3% (10\/121), respectively). Being obese\/overweight (body mass index \u226525 kg\/m\n                      <jats:sup>2<\/jats:sup>\n                      ; p=0.013, adjusted OR (aOR) 2.90, 95% CI 1.25 to 6.74) and ART usage for &gt;3 years (p=0.013, aOR 3.99, 95%\u2009CI 1.55 to 10.28) were independently associated with TB infection.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>There was a high TB infection prevalence among PLHIV. A longer period of ART and obesity were independently associated with TB infection. The relationship between obesity\/overweight and TB infection may be related to ART use and immune reconstitution and requires further investigation. Given the known benefit of test-directed TPT among PLHIV never exposed to TPT, its clinical and cost implications for low and middle-income countries should be explored further.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjresp-2022-001581","type":"journal-article","created":{"date-parts":[[2023,5,17]],"date-time":"2023-05-17T10:55:12Z","timestamp":1684320912000},"page":"e001581","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":7,"title":["Prevalence and predictors of tuberculosis infection among people living with HIV in a high tuberculosis burden context"],"prefix":"10.1136","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5067-0788","authenticated-orcid":false,"given":"Lilian Nkirote","family":"Njagi","sequence":"first","affiliation":[{"name":"Center for Respiratory Disease Research, Kenya Medical Research Institute, Nairobi, Kenya"},{"name":"Department of Medical Microbiology & Immunology, University of Nairobi Faculty of Health Sciences, Nairobi, Kenya"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Videlis","family":"Nduba","sequence":"additional","affiliation":[{"name":"Center for Respiratory Disease Research, Kenya Medical Research Institute, Nairobi, Kenya"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marianne Wanjiru","family":"Mureithi","sequence":"additional","affiliation":[{"name":"Department of Medical Microbiology & Immunology, University of Nairobi Faculty of Health Sciences, Nairobi, Kenya"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jared Ongechi","family":"Mecha","sequence":"additional","affiliation":[{"name":"Department of Clinical Medicine and Therapeutics, University of Nairobi Faculty of Health Sciences, Nairobi, Kenya"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2023,5,17]]},"reference":[{"key":"2025083112174791000_10.1.e001581.1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.282.7.677"},{"key":"2025083112174791000_10.1.e001581.2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.282.7.677"},{"key":"2025083112174791000_10.1.e001581.3","unstructured":"WHO . 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