title: Brief Report: The Effect of Antiretroviral Therapy and CD4 Count on Markers of Infectiousness in HIV-Associated Tuberculosis.
abstract: Clinical features of tuberculosis influence infectiousness. This cross-sectional study examined the effect of combination antiretroviral therapy (cART) and CD4 on sputum smear-positivity (SS+) and pulmonary cavitation among 1589 (1185/1589 HIV-positive) miners in South Africa. Proportions SS+ varied nonlinearly by CD4 with greatest proportions SS+ (55.3%) in the lowest stratum (<100 cells/μL). Adjusted prevalence ratio for SS+; on vs. off cART was 0.90 (95% confidence interval: 0.73 to 1.11). Proportions with cavitation varied linearly with CD4, with no independent cART effect (adjusted prevalence ratio 1.17; 95% confidence interval: 0.80 to 1.71). cART did not independently affect SS+ or cavitation but may increase infectiousness through CD4 recovery.
authors: *Department of Clinical Research, London School of Hygiene and Tropical Medicine, London, United Kingdom; †Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, United Kingdom; ‡The Aurum Institute, Johannesburg, South Africa; §Medical Research Council Clinical Trials Unit at University College London, London, United Kingdom; and ‖School of Public Health, University of Witwatersrand, Johannesburg, South Africa.
authors: Clare L
authors: CL
authors: van Halsema
authors: Katherine L
authors: KL
authors: Fielding
authors: Violet N
authors: VN
authors: Chihota
authors: Elizabeth C
authors: EC
authors: George
authors: James J
authors: JJ
authors: Lewis
authors: Gavin J
authors: GJ
authors: Churchyard
authors: Alison D
authors: AD
authors: Grant
mesh_terms: D000328:Adult; D044966:Anti-Retroviral Agents / Q000627:therapeutic use*; D018791:CD4 Lymphocyte Count; D003430:Cross-Sectional Studies; D005260:Female; D015658:HIV Infections / Q000150:complications* / Q000188:drug therapy* / Q000276:immunology; D006801:Humans; D008168:Lung / Q000473:pathology; D008297:Male; D008875:Middle Aged; D013019:South Africa; D013183:Sputum / Q000382:microbiology; D014376:Tuberculosis / Q000382:microbiology / Q000473:pathology* / Q000635:transmission*
chemical_list: D044966:Anti-Retroviral Agents