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Suárez I, Rauschning D, Schüller C, Hagemeier A, Stecher M, Lehmann C, Schommers P, Schlabe S, Vehreschild JJ, Koll C, Schwarze-Zander C, Wasmuth JC, Klingmüller A, Rockstroh JK, Fätkenheuer G, Boesecke C, Rybniker J. Incidence and risk factors for HIV-tuberculosis coinfection in the Cologne-Bonn region: a retrospective cohort study. Infection 2024:10.1007/s15010-024-02215-y. [PMID: 38492196 DOI: 10.1007/s15010-024-02215-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2023] [Accepted: 02/13/2024] [Indexed: 03/18/2024]
Abstract
PURPOSE The risk of developing active tuberculosis (TB) is considerably increased in people living with HIV/AIDS (PLWH). However, incidence of HIV/TB coinfection is difficult to assess as surveillance data are lacking in many countries. Here, we aimed to perform a quantitative analysis of HIV/TB coinfections within the Cologne/Bonn HIV cohort and to determine risk factors for active TB. METHODS We systematically evaluated data of patients with HIV/TB coinfection between 2006 and 2017. In this retrospective analysis, we compared HIV/TB-coinfected patients with a cohort of HIV-positive patients. The incidence density rate (IDR) was calculated for active TB cases at different time points. RESULTS During 2006-2017, 60 out of 4673 PLWH were diagnosed with active TB. Overall IDR was 0.181 cases/100 patient-years and ranged from 0.266 in 2006-2009 to 0.133 in 2014-2017. Patients originating from Sub-Saharan Africa had a significantly (p < 0.001) higher IDR (0.694/100 patient-years of observation, 95% CI [0.435-1.050]) in comparison to patients of German origin (0.053/100 patient-years of observation, 95% CI [0.028-0.091]). In terms of TB-free survival, individuals originating from countries with a TB incidence higher than 10/100,000 exhibited a markedly reduced TB-free survival compared to those originating from regions with lower incidence (p < 0.001). In 22 patients, TB and HIV infection were diagnosed simultaneously. CONCLUSION Overall, we observed a decline in the incidence density rate (IDR) of HIV/TB coinfections between 2006 and 2017. Patients originating from regions with high incidence bear a higher risk of falling ill with active TB. For PLWH born in Germany, the observed risk of active TB appears to be lower compared to other groups within the cohort. These findings should be considered when developing TB containment and screening strategies for PLWH in low-incidence countries.
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Affiliation(s)
- Isabelle Suárez
- Department I of Internal Medicine, Medical Faculty and University Hospital of Cologne, University of Cologne, Kerpener Str. 62, 50937, Cologne, Germany
- German Center for Infection Research (DZIF), Partner Site Bonn-Cologne, Cologne/Bonn, Germany
| | - Dominic Rauschning
- Department I of Internal Medicine, Medical Faculty and University Hospital of Cologne, University of Cologne, Kerpener Str. 62, 50937, Cologne, Germany
- Department IB of Internal Medicine, Bundeswehrzentralkrankenhaus Koblenz, Koblenz, Germany
| | - Cora Schüller
- Department I of Internal Medicine, Medical Faculty and University Hospital of Cologne, University of Cologne, Kerpener Str. 62, 50937, Cologne, Germany
| | - Anna Hagemeier
- Medical Faculty and University Hospital Cologne, Institute of Medical Statistics and Computational Biology, University of Cologne, Cologne, Germany
| | - Melanie Stecher
- Department I of Internal Medicine, Medical Faculty and University Hospital of Cologne, University of Cologne, Kerpener Str. 62, 50937, Cologne, Germany
- German Center for Infection Research (DZIF), Partner Site Bonn-Cologne, Cologne/Bonn, Germany
| | - Clara Lehmann
- Department I of Internal Medicine, Medical Faculty and University Hospital of Cologne, University of Cologne, Kerpener Str. 62, 50937, Cologne, Germany
- German Center for Infection Research (DZIF), Partner Site Bonn-Cologne, Cologne/Bonn, Germany
- Center for Molecular Medicine Cologne, University of Cologne, Cologne, Germany
| | - Philipp Schommers
- Department I of Internal Medicine, Medical Faculty and University Hospital of Cologne, University of Cologne, Kerpener Str. 62, 50937, Cologne, Germany
- German Center for Infection Research (DZIF), Partner Site Bonn-Cologne, Cologne/Bonn, Germany
- Center for Molecular Medicine Cologne, University of Cologne, Cologne, Germany
| | - Stefan Schlabe
- Department of Medicine I, University Hospital Bonn, Bonn, Germany
| | - Jörg-Janne Vehreschild
- Department I of Internal Medicine, Medical Faculty and University Hospital of Cologne, University of Cologne, Kerpener Str. 62, 50937, Cologne, Germany
- German Center for Infection Research (DZIF), Partner Site Bonn-Cologne, Cologne/Bonn, Germany
- Medical Department 2 (Hematology/Oncology and Infectious Diseases), Center for Internal Medicine, University Hospital, Goethe University Frankfurt, Frankfurt am Main, Germany
| | - Carolin Koll
- Department I of Internal Medicine, Medical Faculty and University Hospital of Cologne, University of Cologne, Kerpener Str. 62, 50937, Cologne, Germany
| | - Carolynne Schwarze-Zander
- German Center for Infection Research (DZIF), Partner Site Bonn-Cologne, Cologne/Bonn, Germany
- Department of Medicine I, University Hospital Bonn, Bonn, Germany
- Gemeinschaftspraxis am Kaiserplatz, Bonn, Germany
| | - Jan-Christian Wasmuth
- German Center for Infection Research (DZIF), Partner Site Bonn-Cologne, Cologne/Bonn, Germany
- Department of Medicine I, University Hospital Bonn, Bonn, Germany
| | - Angela Klingmüller
- Department I of Internal Medicine, Medical Faculty and University Hospital of Cologne, University of Cologne, Kerpener Str. 62, 50937, Cologne, Germany
| | - Jürgen Kurt Rockstroh
- German Center for Infection Research (DZIF), Partner Site Bonn-Cologne, Cologne/Bonn, Germany
- Department of Medicine I, University Hospital Bonn, Bonn, Germany
| | - Gerd Fätkenheuer
- Department I of Internal Medicine, Medical Faculty and University Hospital of Cologne, University of Cologne, Kerpener Str. 62, 50937, Cologne, Germany
- German Center for Infection Research (DZIF), Partner Site Bonn-Cologne, Cologne/Bonn, Germany
| | - Christoph Boesecke
- German Center for Infection Research (DZIF), Partner Site Bonn-Cologne, Cologne/Bonn, Germany
- Department of Medicine I, University Hospital Bonn, Bonn, Germany
| | - Jan Rybniker
- Department I of Internal Medicine, Medical Faculty and University Hospital of Cologne, University of Cologne, Kerpener Str. 62, 50937, Cologne, Germany.
- German Center for Infection Research (DZIF), Partner Site Bonn-Cologne, Cologne/Bonn, Germany.
- Center for Molecular Medicine Cologne, University of Cologne, Cologne, Germany.
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Klingmüller A, Caplan JB, Sommer T. Intrusions in episodic memory: reconsolidation or interference? ACTA ACUST UNITED AC 2017; 24:216-224. [PMID: 28416633 PMCID: PMC5397684 DOI: 10.1101/lm.045047.117] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2017] [Accepted: 03/10/2017] [Indexed: 01/27/2023]
Abstract
It would be profoundly important if reconsolidation research in animals and other memory domains generalized to human episodic memory. A 3-d-list-discrimination procedure, based on free recall of objects, with a contextual reminder cue (the testing room), has been thought to demonstrate reconsolidation of human episodic memory (as noted in a previous study). Our goal was to replicate the central result, a high intrusion rate during recall of the target list, and evaluate the reconsolidation account relative to an alternative account, based on state-dependent learning and interference. First, replication was not straightforward (Experiment 1). Second, using a very unique, highly salient context (Experiment 2), the method produced a qualitative replication, but it was small in magnitude. A critical assumption of the reconsolidation account, that the target list is reactivated and destabilized during re-exposure to the study context, was not supported (Experiment 3). Although troubling for the reconsolidation account, the findings can be easily accommodated by an alternative account that does not assume additional neurobiological processes underlying the destabilization of consolidated memories, instead explaining intrusion rates simply in terms of well-established cognitive effects, such as item-to-context binding and interference during retrieval.
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Affiliation(s)
- Angela Klingmüller
- Department for Systems Neuroscience, Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany
| | - Jeremy B Caplan
- Department for Systems Neuroscience, Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany.,Psychology Department, Neuroscience and Mental Health Institute, University of Alberta, Edmonton, AB T6G 2R3, Canada
| | - Tobias Sommer
- Department for Systems Neuroscience, Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany
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