Journal of acquired immune deficiency syndromes (1999) · 2026
Low Cholesterol Associated With TB in People Living With HIV in an Asia-Pacific Cohort.
СтатьяМногоцентровое исследованиеНазвание и аннотация: Перевод в очереди
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Henry Rebecca T, Khol Vohith, Duy Cuong, Marbaniang Ivan, Somia I Ketut Agus, Kumarasamy Nagalingeswaran, Yunihastuti Evy, Azwa Iskandar, Ditangco Rossana, Kiertiburanakul Sasisopin, Lee Man Po, Avihingsanon Anchalee, Chen Hsin Pai, Chaiwarith Romanee, Khusuwan Suwimon, Pham Thach Ngoc, Pujari Sanjay, Choy Chiaw Yee, Choi Jun Yong, Gani Yasmin, Uemura Haruka, Ross Jeremy, Jiamsakul Awachana, IeDEA Asia-Pacific
Аннотация
BACKGROUND: Tuberculosis (TB) remains the leading cause of illness and death among people living with HIV (PLHIV), particularly in high-burden areas. This study examined associations between TB and routine clinical markers: serum cholesterol, platelet count, and CD4 cell count.
SETTING: The analysis included data from the TREAT Asia HIV Observational Database, a multicenter cohort of adult PLHIV receiving care across the Asia-Pacific region.
METHODS: The authors conducted a cross-sectional matched case-control study of prospective and retrospective patients with TB, comparing clinical and laboratory data within ±3 months of TB diagnosis. Conditional logistic regression assessed associations between TB and covariates.
RESULTS: The analysis included 4244 PLHIV from 20 sites: 1427 patients with TB and 2817 matched controls. Patients with TB were predominantly male (75.3%) and 45.7% aged 31-40 years. Multivariable analysis showed greater odds of TB diagnosis among males, those with low BMI, prior AIDS diagnosis, high HIV viral load, low CD4 + counts, or low total cholesterol. CD4 + counts <200 cells/μL had higher TB odds (adjusted OR [aOR] 12.90, 95% CI: 8.84-18.82) than CD4 + >500 cells/μL. Cholesterol <3.9 mmol/L had higher TB odds (aOR 3.11, 95% CI: 1.94 to 4.98) than cholesterol >5.5 mmol/L.
CONCLUSIONS: In this Asia-Pacific cohort of adults living with HIV, low CD4 + cell count and low total serum cholesterol were associated with increased TB odds. Cholesterol may represent a low-cost adjunct marker to support TB risk stratification in PLHIV in endemic settings, but requires validation and evaluation of feasibility and cost-effectiveness.
SETTING: The analysis included data from the TREAT Asia HIV Observational Database, a multicenter cohort of adult PLHIV receiving care across the Asia-Pacific region.
METHODS: The authors conducted a cross-sectional matched case-control study of prospective and retrospective patients with TB, comparing clinical and laboratory data within ±3 months of TB diagnosis. Conditional logistic regression assessed associations between TB and covariates.
RESULTS: The analysis included 4244 PLHIV from 20 sites: 1427 patients with TB and 2817 matched controls. Patients with TB were predominantly male (75.3%) and 45.7% aged 31-40 years. Multivariable analysis showed greater odds of TB diagnosis among males, those with low BMI, prior AIDS diagnosis, high HIV viral load, low CD4 + counts, or low total cholesterol. CD4 + counts <200 cells/μL had higher TB odds (adjusted OR [aOR] 12.90, 95% CI: 8.84-18.82) than CD4 + >500 cells/μL. Cholesterol <3.9 mmol/L had higher TB odds (aOR 3.11, 95% CI: 1.94 to 4.98) than cholesterol >5.5 mmol/L.
CONCLUSIONS: In this Asia-Pacific cohort of adults living with HIV, low CD4 + cell count and low total serum cholesterol were associated with increased TB odds. Cholesterol may represent a low-cost adjunct marker to support TB risk stratification in PLHIV in endemic settings, but requires validation and evaluation of feasibility and cost-effectiveness.