Publication date: Aug 01, 2026
Tuberculosis (TB) remains the leading cause of death among people living with HIV (PLWH). While tuberculosis preventive treatment (TPT) is universally recommended for PLWH with latent TB infection (LTBI), its necessity for interferon-gamma release assay (IGRA)-negative individuals initiating antiretroviral therapy (ART) is controversial. Therefore, this study aimed to investigate whether TPT is necessary in this specific population. We conducted a retrospective cohort study of ART-nacEFve PLWH with a negative IGRA without prior anti-tuberculosis drug use or active TB at Shanghai Public Health Clinical Center from 2020 to 2024. Demographic characteristics, laboratory results, and TB occurrence during follow-up were recorded. Kaplan-Meier analysis, Cox proportional hazards models, and restricted cubic splines were used to identify risk factors and model the dose-response relationship between CD4 + T-cell count and TB risk. Among 686 participants (89. 4% male, median age 41), the median CD4 + T-cell count was 35. 52 cells/uL. During a 26-month median follow-up, 22 patients developed TB (incidence: 13. 41/1000 person-years). All TB cases occurred in the 583 patients with CD4 + T-cell count
Semantics
| Type | Source | Name |
|---|---|---|
| disease | MESH | tuberculosis |
| pathway | KEGG | Tuberculosis |
| disease | MESH | death |
| disease | MESH | infection |
| pathway | REACTOME | Release |
| disease | MESH | HIV Infections |
| disease | MESH | Latent Tuberculosis |