The socio-demographic, clinical characteristics and outcomes of tuberculosis among HIV infected adults in Lithuania: A thirteen-year analysis

Matulytė, Elžbieta; Davidavičienė, Edita; Kancauskiene, Zavinta; Diktanas, Saulius; Kausas, Aidas; Vėlyvytė, Daiva; Urbonienė, Jurgita; Lipnickiene, Vilnele; Laurencikaite, Megan; Danila, Edvardas; Costagliola, Dominique; Matulionytė, Raimonda

doi:10.1371/journal.pone.0282046

Cited by 3 publications

(3 citation statements)

References 45 publications

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“…Although it is difficult to directly compare very heterogenous cohorts, a recent systematic review found pooled TBrecurrence rates of 4.5 (3.2-5.8) per 100 PYFU among PWH, with higher TB background incidence leading to higher TB recurrence rates [13,17]. In a recent study of PWH treated for TB in Lithuania, 34% developed a recurrent episode of TB, with a median time to recurrence of 4.5 years [14]. Conversely, a study including HIVnegative patients treated for MDR-TB in Russia reported very low recurrence rates after the first year of posttreatment follow-up [0.18/100 PYFU (0.05-0.3)] [15].…”

Section: Discussionmentioning

confidence: 99%

Long-term outcomes after tuberculosis for people with HIV in eastern Europe

Kraef

Bentzon

Roen

et al. 2023

Aids

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Background: Eastern Europe has a high burden of Tuberculosis (TB)/HIV-coinfection with high mortality shortly after TB diagnosis. This study assesses TB recurrence, mortality rates and causes of death among TB/HIV patients from Eastern Europe up to 11 years after TB diagnosis. Methods: A longitudinal cohort study of TB/HIV patients enrolled between 2011–2013 (at TB diagnosis) and followed-up until end of 2021. A competing risk regression was employed to assess rates of TB recurrence, with death as competing event. Kaplan-Maier estimates and a multivariable Cox-regression were used to assess long-term mortality and corresponding risk factors. The Coding Causes of Death in HIV methodology was used for adjudication of causes of death. Results: 375 TB/HIV patients were included. 53 (14·1%) were later diagnosed with recurrent TB (incidence rate 3·1/100 person-years of follow-up (PYFU), 95% CI 2·4–4·0) during a total follow-up time of 1713 PYFU. Twenty-three of 33 patients with data on drug-resistance (69·7%) had MDR-TB. More than half with recurrent TB (n = 30/53, 56·6%) died. Overall, 215 (57·3%) died during the follow-up period, corresponding to a mortality rate of 11·4/100 PYFU (95%CI 10·0–13·1). Almost half of those (48·8%) died of TB. The proportion of all TB-related deaths was highest in the first 6 (n = 49/71; 69·0%; p < 0·0001) and 6 – 24 (n = 33/58; 56·9%; p < 0.0001) months of follow-up, compared deaths beyond 24 months (n = 23/85; 26·7%). Conclusion: TB recurrence and TB-related mortality rates in PLWH in Eastern Europe are still concerningly high and continue to be a clinical and public health challenge.

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Section: Discussionmentioning

confidence: 99%

Long-term outcomes after tuberculosis for people with HIV in eastern Europe

Kraef

Bentzon

Roen

et al. 2023

Aids

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“…Similar prevalence rates have been estimated in other European countries, such as The Netherlands and Finland [ 18 , 19 ]. A few studies of causes, socio-demographic factors, clinical presentation, and outcomes of infectious diseases have been conducted in Lithuania [ 15 , 20 ]. For example, Matulyte et al investigated data of patients with a diagnosis of bacterial meningitis treated between 2009 and 2016 [ 15 ].…”

Section: Introductionmentioning

confidence: 99%

Etiology, Clinical Presentation, and Outcomes of Bacterial Meningitis in Adult Patients: A Retrospective Study in Lithuania (2018-2021)

Rynkevič,

Žilinskas,

Streckytė

et al. 2024

Med Sci Monit

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Background Bacterial meningitis is a serious and life-threatening condition that requires prompt diagnosis and treatment. This retrospective study aimed to identify causes, presentation, and predictive factors for outcomes of community-acquired bacterial meningitis in 86 adults in Vilnius, Lithuania between 2018 and 2021. Material/Methods We performed a retrospective study of demographic, clinical, and laboratory records of 86 adult patients admitted to Vilnius University Hospital Santaros Clinics with a diagnosis of acute bacterial meningitis during the period of 2018–2021. Results Of 86 patients, 54 (62.79%) were men. The median (Md) age of patients was 58 (range, 18–83) years and the median duration of hospitalization was 20 (range, 3–92) days. Patients were first hospitalized in the Intensive Care Unit (ICU) in 59.3% of cases. The most prevalent concerns were headache (66.28%), febrile temperature (56.98%), general fatigue (53.49%), and confusion/sleepiness (52.33%). Of 57 (66.28%) etiologically confirmed cases, the most prevalent agent was Listeria monocytogenes (29.82%), followed by Streptococcus pneumoniae (28.07%) and Neisseria meningitidis (28.07%). Patients with meningitis caused by L. monocytogenes were the oldest ( P =0.003) and had the longest hospitalization ( P <0.001). Fatigue was the prominent symptom in patients with meningococcal meningitis (81.2%, P =0.010). Twelve patients (13.95%) have died. Advanced age and low (<100 cells per μL) white blood cell (WBC) count in cerebrospinal fluid (CSF) were associated with lethal outcome, whereas headache was associated with favorable outcome. Conclusions Clinical characteristics of community-acquired acute bacterial meningitis differ based on etiological factors. Patient age, CSF WBC count, and headache may be significant predictive factors for outcomes of bacterial meningitis.

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“…TB continues to be a public health problem in Lithuania, as one of the 18 high-priority TB countries in the European region. Lithuania has one of the highest rates of TB in the European region (ranging from 40.7/10,000 in 2018 to 26.3/100,000 in 2022) [ 1 , 12 , 13 , 14 , 15 , 16 ] and out of the cumulative number of all 3431 PLHIV in Lithuania at the end of 2020 [ 17 ], 311 (9.1%) patients were registered with active TB [ 18 ]. TB is the most common AIDS-defining condition in Lithuania; its proportion has been the highest in the EU/EEA since 2015 and was still >50% of all AIDS-defining conditions in 2019 [ 19 ].…”

Section: Introductionmentioning

confidence: 99%

Latent Tuberculosis Infection and Associated Risk Factors among People Living with HIV and HIV-Uninfected Individuals in Lithuania

Matulyte,

Kancauskiene,

Kausas

et al. 2023

Pathogens

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Background: People living with HIV (PLHIV) with latent tuberculosis infection (LTBI) are at increased risk of tuberculosis (TB) reactivation compared to the HIV-negative population. Lithuania belongs to the 18 high-priority TB countries in the European region. The aim of this study was to compare the prevalence of LTBI and LTBI-related risk factors between PLHIV and HIV-uninfected populations. Methods: A cross-sectional study was conducted in three Lithuanian Infectious Diseases centres from August 2018 to May 2022 using the interferon gamma release assay (IGRA) and tuberculin skin test (TST) in Vilnius, and IGRA only in Siauliai and Klaipeda. Cohen’s kappa was used to assess IGRA and TST agreement. A structured questionnaire was completed by the study participants. LTBI-related risk factors were identified using a multivariable logistic regression model. Results: In total, 391 PLHIV and 443 HIV-uninfected individuals enrolled, with a median age of 41 (IQR 36–48) and 43 (IQR 36–50), consisting of 69.8% and 65.5% male, respectively. The prevalence of LTBI defined by positive IGRA and/or TST among PLHIV was higher compared to that in the HIV-uninfected population (20.5% vs. 15.3%; OR 1.42; 95% CI 1.02–2.03; p = 0.04). The concordance between IGRA and TST was fair: kappa = 0.23 (95% CI 0.09–0.34). In multivariable analyses, association with injecting drug use (IDU) (ORa 2.25, 95% CI 1.27–3.99, p = 0.01) and imprisonment (ORa 1.99, 95% CI 1.13–3.52, p = 0.02) in all participants, IDU (ORa 2.37, 95% CI 1.09–5.15; p = 0.029) in PLHIV and a history of contact with an active TB patient (ORa 3.33, 95% CI 1.53–7.24; p = 0.002) in HIV-uninfected individuals were significant associations evidenced by LTBI. Conclusions: The prevalence of LTBI among PLHIV in Lithuania is higher compared to that in the HIV-uninfected population and the European average. The association with IDU in PLHIV emphasizes the need for integrated HIV, TB and substance abuse treatment to provide patient-centred care.

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The socio-demographic, clinical characteristics and outcomes of tuberculosis among HIV infected adults in Lithuania: A thirteen-year analysis

Cited by 3 publications

References 45 publications

Long-term outcomes after tuberculosis for people with HIV in eastern Europe

Long-term outcomes after tuberculosis for people with HIV in eastern Europe

Etiology, Clinical Presentation, and Outcomes of Bacterial Meningitis in Adult Patients: A Retrospective Study in Lithuania (2018-2021)

Latent Tuberculosis Infection and Associated Risk Factors among People Living with HIV and HIV-Uninfected Individuals in Lithuania

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