title: Incidence of tuberculosis in HIV-infected patients in Spain: the impact of treatment for LTBI.
abstract: METHODS
  Twenty hospitals in Spain.
  
  
  OBJECTIVE
  To describe the incidence of active tuberculosis (TB) and factors related to TB development after treatment for latent tuberculous infection (TLTBI) in human immunodeficiency virus-1 (HIV-1) infected patients in the highly active antiretroviral therapy era.
  
  
  METHODS
  In a multicentre cohort of HIV-1-infected patients, we calculated TB incidence by tuberculin skin test (TST) results and TLTBI, and factors associated with a positive TST and the development of TB after TLTBI.
  
  
  RESULTS
  Of 7902 patients, 6.5% had a history of TB at enrolment: 168 patients developed TB during 10,889 person-years (py) of follow-up, corresponding to an incidence rate of 1.54 cases per 100 py (95%CI 1.33-1.80). TB incidence in TST-positive patients who did not receive TLTBI was three times higher (6 cases/100 py) than in those who did (1.75 cases/100 py). In patients who received TLTBI, risk of development of TB was higher among cases aged <35 years (HR 6.14, 95%CI 1.12-33.73) and in those with a nadir CD4(+) cell count of <200 cells/μl (HR 5.64, 95%CI 1.34-23.70).
  
  
  CONCLUSIONS
  TLTBI is effective in preventing the development of TB in HIV-infected patients, particularly in those who were TST-positive.
authors.affiliation: Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain; CIBER de Epidemiología y Salud Pública, Institute of Health Carlos III, Madrid, Spain.
authors.forename: I
authors.initials: I
authors.lastname: Martínez-Pino
authors.forename: M A
authors.initials: MA
authors.lastname: Sambeat
authors.forename: J R
authors.initials: JR
authors.lastname: Lacalle-Remigio
authors.forename: P
authors.initials: P
authors.lastname: Domingo
mesh_terms: D000328:Adult; D000995:Antitubercular Agents / Q000627:therapeutic use*; D018791:CD4 Lymphocyte Count; D060085:Coinfection; D005260:Female; D015658:HIV Infections / Q000175:diagnosis / Q000453:epidemiology* / Q000821:virology; D015497:HIV-1 / Q000302:isolation & purification; D006801:Humans; D015994:Incidence; D055985:Latent Tuberculosis / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology*; D008297:Male; D011237:Predictive Value of Tests; D011446:Prospective Studies; D013030:Spain / Q000453:epidemiology; D013997:Time Factors; D016896:Treatment Outcome; D014374:Tuberculin Test
chemical_list: D000995:Antitubercular Agents