Factors Associated With Tuberculosis as an AIDS-Defining Disease in an Immigration Setting

Abstract

BackgroundImmigration can affect the evolution of TB as an AIDS-defining disease (AIDS–TB).MethodsThe Barcelona AIDS register for 1994–2005 was analyzed, and the global characteristics of AIDS–TB and AIDS–non-TB cases were compared. The Mantel-Haenszel test was used in the trend analysis, and logistic regression was used in the multivariate analysis.ResultsOf the 3600 cases studied, 1130 had both AIDS and TB. A declining trend in AIDS–TB rates was observed in both sexes among both immigrants and native residents. The percentage of AIDS–TB was significantly higher among immigrants (P = 0.02). The number of cases among immigrants remained constant over the period of study, but decreased among native residents. The sociodemographic and immunological characteristics associated with TB were male sex, age younger than 36 years, inner city residence, a record of incarceration, greater than 200 CD4+ T-cells/mm3, injecting drug use, heterosexual sex, and immigration from Latin America, the Caribbean, or sub-Saharan Africa.ConclusionsThe incidence of TB as an AIDS-defining disease decreased in Barcelona during a recent 10-year period in both native and immigrant populations. However, immigrants remain a high-risk group for AIDS–TB and should be targeted for surveillance and control of both diseases.

HIV and tuberculosis co-infection among migrants in Europe: A systematic review on the prevalence, incidence and mortality

“…The main study design was retrospective—eight studies [ 22 – 24 , 28 , 29 , 39 , 40 , 42 ]—followed by six prospective/cohort studies [ 34 , 36 , 37 , 41 , 45 , 46 ] (one of them also multicentric [ 34 ]), two population-based studies [ 31 , 43 ], one quasi-experimental study [ 26 ] and one multicentric study [ 35 ]. The remaining studies did not mention the adopted study design [ 20 , 21 , 25 , 27 , 30 , 32 , 33 , 38 , 44 ] ( Table 1 ).…”

“…The sample size ranged between studies from 69 [ 22 ] to 72580 subjects [ 36 , 37 ]. The included subjects varied between studies: some studies included patients diagnosed with TB [ 27 , 28 , 32 , 38 – 40 ], HIV/AIDS [ 20 , 24 , 36 , 37 , 41 , 46 ], or HIV-TB co-infection [ 30 , 33 , 34 , 43 ]. Other studies included immigrant patients [ 21 , 35 ], immigrant/foreign-born TB patients [ 26 , 29 , 39 , 42 ], immigrant/foreign-born HIV patients [ 22 , 23 , 25 , 45 , 46 ], and immigrant/foreign-born HIV-TB patients [ 42 ].…”

“…Among these, 10 studies reported prevalence numbers of HIV-TB co-infection in immigrants and nationals [ 20 , 21 , 24 , 27 , 32 , 37 – 40 , 44 ]. Prevalence of co-infection was higher among immigrants than among nationals in 7 studies conducted in France, Portugal, Spain and UK [ 20 , 24 , 37 – 40 , 44 ]—range of 2.8%-85% among migrants vs. 2.3%-30.8% among nationals ( Table 2 )—, of which, one study was based on national registries from Portugal (2008–2012) [ 39 ]. Contradictory results were observed in 3 studies [ 21 , 27 , 32 ]—ranging between 6%-6.8% among migrants vs. 2.3%-37% among nationals ( Table 2 ).…”

Inequalities in HIV disease management and progression in migrants from Latin America and sub‐Saharan Africa living in Spain

“…A higher risk of AIDS in those aged between 35 and 50 years was found for SSA and LAC as a result of a higher rate of tuberculosis, which is prevalent in groups with poor living conditions or who come from endemic areas .…”

Hispano-Americans in Europe: what do we know about their health status and determinants? A scoping review

“…In Italy and Switzerland HAs were at higher risk of TB than migrants from other areas [ 65 , 66 ]. In Spain, HAs were more likely to develop TB as an AIDS defining disease than locals [ 67 ] and HA inmates were at higher risk of latent TB than Spanish-born prisoners [ 68 ].…”