TB Is Uncommon After ART Initiation in the U.S. — but Not Unheard Of

Risk factors include a low CD4-cell count at ART initiation, a history of injection-drug use, and nonwhite race.

Antiretroviral therapy (ART) dramatically reduces the risk for tuberculosis (TB), but in the first 3 months of ART, the risk for developing this disease is reportedly very high, even in developed countries (1300 to 1700 cases per 100,000 person-years). Despite this risk, patients in the U.S. and Canada are not routinely screened for latent or active TB before starting ART. Now, the results of a large NA-ACCORD analysis indicate which patients might benefit most from such screening.

Investigators studied 37,845 patients in the U.S. and Canada who initiated potent ART between December 1995 and August 2009. The study population was mostly male (77%) but racially diverse (43% white; 38% black), with a median age of 39. The median CD4 count prior…

Reviewing Author

Carlos del Rio, MD

TB Is Uncommon After ART Initiation in the U.S. — but Not Unheard Of

Topics

Reviewing Author