{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T20:17:02Z","timestamp":1787170622408,"version":"build-2736575974"},"reference-count":49,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2023,7,28]],"date-time":"2023-07-28T00:00:00Z","timestamp":1690502400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Run-up to programmatic management of latent tuberculosis infection in HIV-infected people in Lithuania","award":["482020"],"award-info":[{"award-number":["482020"]}]},{"name":"Western-Eastern European Partnership Initiative on HIV, Viral Hepatitis and TB","award":["482020"],"award-info":[{"award-number":["482020"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pathogens"],"abstract":"<jats:p>Background: People living with HIV (PLHIV) with latent tuberculosis infection (LTBI) are at increased risk of tuberculosis (TB) reactivation compared to the HIV-negative population. Lithuania belongs to the 18 high-priority TB countries in the European region. The aim of this study was to compare the prevalence of LTBI and LTBI-related risk factors between PLHIV and HIV-uninfected populations. Methods: A cross-sectional study was conducted in three Lithuanian Infectious Diseases centres from August 2018 to May 2022 using the interferon gamma release assay (IGRA) and tuberculin skin test (TST) in Vilnius, and IGRA only in Siauliai and Klaipeda. Cohen\u2019s kappa was used to assess IGRA and TST agreement. A structured questionnaire was completed by the study participants. LTBI-related risk factors were identified using a multivariable logistic regression model. Results: In total, 391 PLHIV and 443 HIV-uninfected individuals enrolled, with a median age of 41 (IQR 36\u201348) and 43 (IQR 36\u201350), consisting of 69.8% and 65.5% male, respectively. The prevalence of LTBI defined by positive IGRA and\/or TST among PLHIV was higher compared to that in the HIV-uninfected population (20.5% vs. 15.3%; OR 1.42; 95% CI 1.02\u20132.03; p = 0.04). The concordance between IGRA and TST was fair: kappa = 0.23 (95% CI 0.09\u20130.34). In multivariable analyses, association with injecting drug use (IDU) (ORa 2.25, 95% CI 1.27\u20133.99, p = 0.01) and imprisonment (ORa 1.99, 95% CI 1.13\u20133.52, p = 0.02) in all participants, IDU (ORa 2.37, 95% CI 1.09\u20135.15; p = 0.029) in PLHIV and a history of contact with an active TB patient (ORa 3.33, 95% CI 1.53\u20137.24; p = 0.002) in HIV-uninfected individuals were significant associations evidenced by LTBI. Conclusions: The prevalence of LTBI among PLHIV in Lithuania is higher compared to that in the HIV-uninfected population and the European average. The association with IDU in PLHIV emphasizes the need for integrated HIV, TB and substance abuse treatment to provide patient-centred care.<\/jats:p>","DOI":"10.3390\/pathogens12080990","type":"journal-article","created":{"date-parts":[[2023,7,28]],"date-time":"2023-07-28T07:58:52Z","timestamp":1690531132000},"page":"990","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Latent Tuberculosis Infection and Associated Risk Factors among People Living with HIV and HIV-Uninfected Individuals in Lithuania"],"prefix":"10.3390","volume":"12","author":[{"given":"Elzbieta","family":"Matulyte","sequence":"first","affiliation":[{"name":"Department of Infectious Diseases and Dermatovenerology, Faculty of Medicine, Vilnius University Hospital Santaros Klinikos, Vilnius University, LT-08410 Vilnius, Lithuania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zavinta","family":"Kancauskiene","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, University Hospital of Klaipeda, LT-92888 Klaipeda, Lithuania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aidas","family":"Kausas","sequence":"additional","affiliation":[{"name":"Adult Infectious Diseases Unit, Clinic of Conservative Medicine, Republican Siauliai County Hospital, LT-76231 Siauliai, Lithuania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jurgita","family":"Urboniene","sequence":"additional","affiliation":[{"name":"Centre of Infectious Diseases, Vilnius University Hospital Santaros Klinikos, LT-08410 Vilnius, Lithuania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vilnele","family":"Lipnickiene","sequence":"additional","affiliation":[{"name":"National Public Health Surveillance Laboratory, LT-10210 Vilnius, Lithuania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jelena","family":"Kopeykiniene","sequence":"additional","affiliation":[{"name":"Department of Diagnostics, University Hospital of Klaipeda, LT-92888 Klaipeda, Lithuania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tomas","family":"Gudaitis","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Vilnius University, LT-03101 Vilnius, Lithuania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarunas","family":"Raudonis","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Vilnius University, LT-03101 Vilnius, Lithuania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edvardas","family":"Danila","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Institute of Clinical Medicine, Clinic of Chest Diseases, Immunology, and Allergology, Vilnius University, LT-03101 Vilnius, Lithuania"},{"name":"Centre of Pulmonology and Allergology, Vilnius University Hospital Santaros Klinikos, LT-08661 Vilnius, Lithuania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dominique","family":"Costagliola","sequence":"additional","affiliation":[{"name":"Institut Pierre Louis \u00c9pid\u00e9miologie de Sant\u00e9 Publique, Sorbonne Universit\u00e9, INSERM, F75013 Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raimonda","family":"Matulionyte","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases and Dermatovenerology, Faculty of Medicine, Vilnius University Hospital Santaros Klinikos, Vilnius University, LT-08410 Vilnius, Lithuania"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,7,28]]},"reference":[{"key":"ref_1","unstructured":"WHO (2021). Global Tuberculosis Report 2021."},{"key":"ref_2","unstructured":"European Centre for Disease Prevention and Control\/WHO Regional Office for Europe (2021). HIV\/AIDS Surveillance in Europe 2021\u20132020 Data, World Health Organization."},{"key":"ref_3","unstructured":"Kaef, C., Benzon, A., Panteleev, A., Skrahina, A., Bolokadze, N., Tetradov, S., Podlasin, R., Karpov, I., Borodulina, E., and Denisova, E. (2021). Delayed diagnosis of tuberculosis in persons living with HIV in Eastern Europe: Associated factors and effect on mortality\u2014A multicentre prospective cohort study. BMC Infect. Dis., 21."},{"key":"ref_4","unstructured":"WHO (2018). Latent Tuberculosis Infection: Updated and Consolidated Guidelines for Programmatic Management, Licence: CC BY-NC-SA 3.0 IGO."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"677","DOI":"10.1001\/jama.282.7.677","article-title":"Consensus statement. Global burden of tuberculosis: Estimated incidence, prevalence, and mortality by country. WHO Global Surveillance and Monitoring Project","volume":"282","author":"Dye","year":"1999","journal-title":"J. Am. Med. Assoc."},{"key":"ref_6","doi-asserted-by":"crossref","unstructured":"Houben, R.M., and Dodd, P.J. (2016). The Global Burden of Latent Tuberculosis Infection: A Re-estimation Using Mathematical Modelling. PLoS Med., 13.","DOI":"10.1371\/journal.pmed.1002152"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"2127","DOI":"10.1056\/NEJMra1405427","article-title":"Latent Mycobacterium tuberculosis infection","volume":"372","author":"Getahun","year":"2015","journal-title":"N. Engl. J. Med."},{"key":"ref_8","unstructured":"WHO (2022). Guidelines on the Management of Latent Tuberculosis Infection."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"1701578","DOI":"10.1183\/13993003.01578-2017","article-title":"Intensity of exposure to pulmonary tuberculosis determines risk of tuberculosis infection and disease","volume":"51","author":"Fregona","year":"2018","journal-title":"Eur. Respir. J."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"1190","DOI":"10.1016\/S1473-3099(17)30447-4","article-title":"A score to predict and stratify risk of tuberculosis in adult contacts of tuberculosis index cases: A prospective derivation and external validation cohort study","volume":"17","author":"Saunders","year":"2017","journal-title":"Lancet Infect. Dis."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"1801616","DOI":"10.1183\/13993003.01616-2018","article-title":"Escaping the Plato\u2019s cave of latent tuberculosis testing: A path for developers of predictive tests for risk of tuberculosis","volume":"52","author":"Ruhwald","year":"2018","journal-title":"Eur. Respir. J."},{"key":"ref_12","unstructured":"European Centre for Disease Prevention and Control\/WHO Regional Office for Europe (2020). Tuberculosis Surveillance and Monitoring in Europe 2020\u20142018 Data, World Health Organization."},{"key":"ref_13","unstructured":"European Centre for Disease Prevention and Control\/WHO Regional Office for Europe (2021). Tuberculosis Surveillance and Monitoring in Europe 2021\u20142019 Data, World Health Organization."},{"key":"ref_14","unstructured":"European Centre for Disease Prevention and Control\/WHO Regional Office for Europe (2022). Tuberculosis Surveillance and Monitoring in Europe 2022\u20142021 Data, World Health Organization."},{"key":"ref_15","unstructured":"European Centre for Disease Prevention and Control\/WHO Regional Office for Europe (2023). Tuberculosis Surveillance and Monitoring in Europe 2023\u20142021 Data, World Health Organization."},{"key":"ref_16","unstructured":"(2022, July 15). The State Information System of Tuberculosis Home Page. Available online: https:\/\/2014.esinvesticijos.lt\/lt\/dokumentai\/\/2014-2020-metu-europos-sajungos-fondu-investiciju-veiksmu-programos-8-prioriteto-socialines-itraukties-didinimas-ir-kova-su-skurdu-priemones-nr-08-4-2-esfa-r-615-priemoniu-gerinanciu-ambulatoriniu-sveikatos-prieziuros-paslaugu-prieinamuma-tuberkulioz\/tuberkuliozes-valstybes-informacines-sistemos-registro-duomenys."},{"key":"ref_17","unstructured":"(2022, July 17). The Centre for Communicable Diseases and AIDS Home Page. Available online: https:\/\/nvsc.lrv.lt."},{"key":"ref_18","doi-asserted-by":"crossref","unstructured":"Matulyte, E., Davidaviciene, E., Kancauskiene, Z., Diktanas, S., Kausas, A., Velyvyte, D., Urboniene, J., Lipnickiene, V., Laurencikaite, M., and Danila, E. (2023). The socio-demographic, clinical characteristics and outcomes of tuberculosis among HIV infected adults in Lithuania: A thirteen-year analysis. PLoS ONE, 18.","DOI":"10.1371\/journal.pone.0282046"},{"key":"ref_19","unstructured":"European Centre for Disease Prevention and Control\/WHO Regional Office for Europe (2020). HIV\/AIDS Surveillance in Europe 2020\u20132019 Data, World Health Organization."},{"key":"ref_20","unstructured":"WHO (2012). Recommendations for Investigating Contacts of Persons with Infectious Tuberculosis in Low- and Middle-Income Countries."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"363","DOI":"10.2307\/2529786","article-title":"An application of hierarchical kappa-type statistics in the assessment of majority agreement among multiple observers","volume":"33","author":"Landis","year":"1977","journal-title":"Biometrics"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"1900655","DOI":"10.1183\/13993003.00655-2019","article-title":"The global prevalence of latent tuberculosis: A systematic review and meta-analysis","volume":"54","author":"Cohen","year":"2019","journal-title":"Eur. Respir. J."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"729","DOI":"10.1016\/j.jmii.2014.08.010","article-title":"Prevalence of latent tuberculosis infection in persons with and without human immunodeficiency virus infection using two interferon-gamma release assays and tuberculin skin test in a low human immunodeficiency virus prevalence, intermediate tuberculosis-burden country","volume":"49","author":"Lin","year":"2016","journal-title":"J. Microbiol. Immunol. Infect."},{"key":"ref_24","doi-asserted-by":"crossref","unstructured":"Latorre, I., Mart\u00ednez-Lacasa, X., Font, R., Lacoma, A., Puig, J., Tural, C., Lite, J., Prat, C., Cuchi, E., and Ausina, V. (2010). IFN-\u03b3 response on T-cell based assays in HIV-infected patients for detection of tuberculosis infection. BMC Infect. Dis., 10.","DOI":"10.1186\/1471-2334-10-348"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"230","DOI":"10.1097\/QAI.0b013e31820b07ab","article-title":"Interferon-gamma release assays for the diagnosis of latent tuberculosis infection in HIV-infected individuals: A systematic review and meta-analysis","volume":"56","author":"Cattamanchi","year":"2011","journal-title":"J. Acquir. Immune. Defic. Syndr."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"43","DOI":"10.4103\/1817-1737.58959","article-title":"Performance of QuantiFERON-TB Gold test compared to tuberculin skin test in detecting latent tuberculosis infection in HIV-positive individuals in Iran","volume":"5","author":"Mardani","year":"2010","journal-title":"Ann. Thorac. Med."},{"key":"ref_27","doi-asserted-by":"crossref","unstructured":"Chkhartishvili, N., Kempker, R.R., Dvali, N., Abashidze, L., Sharavdze, L., Gabunia, P., Blumberg, H.M., del Rio, C., and Tsertsvadze, T. (2013). Poor agreement between interferon-gamma release assays and the tuberculin skin test among HIV-infected individuals in the country of Georgia. BMC Infect. Dis., 13.","DOI":"10.1186\/1471-2334-13-513"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"829","DOI":"10.1128\/JCM.42.2.829-831.2004","article-title":"Gamma interferon-based immunodiagnosis of tuberculosis: Comparison between whole-blood and enzyme-linked immunospot methods","volume":"42","author":"Wilkinson","year":"2004","journal-title":"J. Clin. Microbiol."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"10093","DOI":"10.1038\/s41598-019-46570-5","article-title":"A longitudinal study on latent TB infection screening and its association with TB incidence in HIV patients","volume":"9","author":"Wong","year":"2019","journal-title":"Sci. Rep."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"489","DOI":"10.1586\/14787210.2016.1168693","article-title":"Screening and treatment of latent tuberculosis infection among HIV-infected patients in resource-rich settings","volume":"14","author":"Lin","year":"2016","journal-title":"Expert. Rev. Anti. Infect. Ther."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"1168","DOI":"10.1164\/rccm.201405-0967OC","article-title":"Risk assessment of tuberculosis in immunocompromised patients","volume":"190","author":"Sester","year":"2014","journal-title":"TBNET Study Am. J. Respir. Crit. Care Med."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"85","DOI":"10.1016\/S1473-3099(21)00145-6","article-title":"Tuberculosis Epidemiologic Studies Consortium. Comparison of three tests for latent tuberculosis infection in high-risk people in the USA: An observational cohort study","volume":"22","author":"Ho","year":"2022","journal-title":"Lancet Infect. Dis."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"536","DOI":"10.1016\/j.jinf.2020.02.009","article-title":"Effect of HIV-infection on QuantiFERON-plus accuracy in patients with active tuberculosis and latent infection","volume":"80","author":"Petruccioli","year":"2020","journal-title":"J. Infect."},{"key":"ref_34","doi-asserted-by":"crossref","unstructured":"Yang, C.H., Chan, P.C., Liao, S.T., Cheng, S.H., Wong, W.W., Huang, L.M., Hsueh, P.R., and Chiou, H.Y. (2013). Strategy to better select HIV-infected individuals for latent TB treatment in BCG-vaccinated population. PLoS ONE, 8.","DOI":"10.1371\/journal.pone.0073069"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"2003","DOI":"10.1001\/jama.283.15.2003","article-title":"The case against anergy testing as a routine adjunct to tuberculin skin testing","volume":"283","author":"Slovis","year":"2000","journal-title":"J. Am. Med. Assoc."},{"key":"ref_36","doi-asserted-by":"crossref","unstructured":"World Health Organization (2018). BCG vaccine: WHO position paper, February 2018\u2014Recommendations. Vaccine, 36, 3408\u20133410.","DOI":"10.1016\/j.vaccine.2018.03.009"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"282","DOI":"10.1016\/j.chest.2017.01.001","article-title":"The Long-term Effect of Bacille Calmette-Gu\u00e9rin Vaccination on Tuberculin Skin Testing: A 55-Year Follow-Up Study","volume":"152","author":"Mancuso","year":"2017","journal-title":"Chest"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"2746","DOI":"10.1001\/jama.293.22.2746","article-title":"Mycobacterium tuberculosis infection in health care workers in rural India: Comparison of a whole-blood interferon gamma assay with tuberculin skin testing","volume":"293","author":"Pai","year":"2005","journal-title":"J. Am. Med. Assoc."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"47","DOI":"10.1177\/2325957412469687","article-title":"The performance of quantiferon-TB gold in-tube (QFT-IT) test compared to tuberculin skin test (TST) in detecting latent tuberculosis infection (LTBI) in the presence of HIV coinfection in a high TB-burden area with BCG-vaccinated population","volume":"13","author":"James","year":"2014","journal-title":"J. Int. Assoc. Provid. AIDS Care"},{"key":"ref_40","doi-asserted-by":"crossref","unstructured":"Sharma, S.K., Vashishtha, R., Chauhan, L.S., Sreenivas, V., and Seth, D. (2017). Comparison of TST and IGRA in Diagnosis of Latent Tuberculosis Infection in a High TB-Burden Setting. PLoS ONE, 12.","DOI":"10.1371\/journal.pone.0169539"},{"key":"ref_41","doi-asserted-by":"crossref","unstructured":"Ayubi, E., Doosti-Irani, A., Sanjari Moghaddam, A., Sani, M., Nazarzadeh, M., and Mostafavi, E. (2016). The Clinical Usefulness of Tuberculin Skin Test versus Interferon-Gamma Release Assays for Diagnosis of Latent Tuberculosis in HIV Patients: A Meta-Analysis. PLoS ONE, 11, Erratum in PLoS ONE2016, 11, e0165143.","DOI":"10.1371\/journal.pone.0165143"},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"210079","DOI":"10.1183\/20734735.0079-2021","article-title":"The definition of tuberculosis infection based on the spectrum of tuberculosis disease","volume":"17","author":"Migliori","year":"2021","journal-title":"Breathe"},{"key":"ref_43","doi-asserted-by":"crossref","unstructured":"Tilahun, M., Shibabaw, A., Kiflie, A., Bewket, G., Abate, E., and Gelaw, B. (2019). Latent tuberculosis infection and associated risk factors among people living with HIV and apparently healthy blood donors at the University of Gondar referral hospital, Northwest Ethiopia. BMC Res. Notes, 12.","DOI":"10.1186\/s13104-019-4548-x"},{"key":"ref_44","doi-asserted-by":"crossref","unstructured":"Chen, C., Zhu, T., Wang, Z., Peng, H., Kong, W., Zhou, Y., Shao, Y., Zhu, L., and Lu, W. (2015). High Latent TB Infection Rate and Associated Risk Factors in the Eastern China of Low TB Incidence. PLoS ONE, 10.","DOI":"10.1371\/journal.pone.0141511"},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"175","DOI":"10.1016\/j.drugpo.2013.10.002","article-title":"Prevalence of IGRA-positivity and risk factors for tuberculosis among injecting drug users in Estonia and Latvia","volume":"25","author":"Karnite","year":"2014","journal-title":"Int. J. Drug Policy"},{"key":"ref_46","first-page":"170","article-title":"The diagnosis of latent tuberculosis infection (LTBI): Currently available tests, future developments, and perspectives to eliminate tuberculosis (TB)","volume":"111","author":"Zellweger","year":"2020","journal-title":"Med. Lav."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"1000663","DOI":"10.3389\/fcimb.2022.1000663","article-title":"Prevalence of latent tuberculosis infection and incidence of active tuberculosis in school close contacts in Shanghai, China: Baseline and follow-up results of a prospective cohort study","volume":"12","author":"Xiao","year":"2022","journal-title":"Front. Cell Infect. Microbiol."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"19317","DOI":"10.7448\/IAS.18.1.19317","article-title":"Active and latent tuberculosis among HIV-positive injecting drug users in Indonesia","volume":"18","author":"Meijerink","year":"2015","journal-title":"J. Int. AIDS Soc."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"48","DOI":"10.1111\/hiv.13163","article-title":"Improving healthcare for patients with HIV, tuberculosis and hepatitis C in eastern Europe: A review of current challenges and important next steps","volume":"23","author":"Kraef","year":"2022","journal-title":"HIV Med."}],"container-title":["Pathogens"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2076-0817\/12\/8\/990\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T20:21:18Z","timestamp":1760127678000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2076-0817\/12\/8\/990"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,7,28]]},"references-count":49,"journal-issue":{"issue":"8","published-online":{"date-parts":[[2023,8]]}},"alternative-id":["pathogens12080990"],"URL":"https:\/\/doi.org\/10.3390\/pathogens12080990","relation":{},"ISSN":["2076-0817"],"issn-type":[{"value":"2076-0817","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,7,28]]}}}