| Titre : | Infectiousness of Mycobacterium tuberculosis in HIV-1-infected patients with tuberculosis : a prospective study. (2000) |
| Auteurs : | M.A. Espinal ; J. BAEZ ; K. Fernandez ; L. HENRIQUEZ ; M. LOPEZ ; P. OLIVO ; E.N. Perez ; A.L. REINGOLD ; National Centre for Research on Maternal and Child Health. Santo Domingo. DOM |
| Type de document : | Article |
| Dans : | Lancet (The) (vol. 355, n° 9200, 2000) |
| Pagination : | 275-280 |
| Langues: | Anglais |
| Mots-clés : | Tuberculose ; Bactériose ; Infection ; Poumon ; Bactérie ; Sida ; Virose ; VIH ; Rétrovirus ; Virus ; Complication ; Epidémiologie ; Facteur risque ; Homme ; Etude prospective ; Saint Domingue ; Antilles ; Amérique ; Appareil respiratoire [pathologie] ; Tuberculose pulmonaire ; Immunopathologie ; Amérique centrale |
| Résumé : | [BDSP. Notice produite par INIST tGaR0xpM. Diffusion soumise à autorisation]. Background Previous studies concerning the relative infectiousness of HIV-1-positive individuals with pulmonary tuberculosis have produced conflicting results. Thus, we assessed the effect of HIV-1 on the infectiousness of Mycobacterium tuberculosis in a prospective study. Methods We organised in Santo Domingo, Dominican Republic, a cohort study of household contacts of HIV-1-positive and HIV-1-negative individuals with newly diagnosed pulmonary tuberculosis. Household contacts were assessed at their houses at baseline and followed up for 14 months for evidence of M tuberculosis infection and tuberculosis with a multi-step tuberculin skin test, anergy skin test, physical examinations, chest radiographs, and sputum smears. Findings Tuberculin induration of 5 mm or greater was seen in 153 (61%) of 252 household contacts of HIV-1-positive index cases and in 418 (76%) of 551 household contacts of HIV-1-negative index cases (odds ratio 0.49 [95% Cl 0.35-0.67], p=0.00001). In multivariate logistic-regression analysis after allowance for between-household variation in tuberculin response, HIV-1 infection of the index case remained inversely associated with the tuberculin response of the household contacts (0.52 [0.29-0.93], p=0.02). When the analysis was restricted to household contacts aged between 2 years and 15 years the adjusted association remained significant (0.37 [0.14-0.98], p=0.04). (...) |
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