Abstract Background Emerging evidence suggests that human cytomegalovirus (HCMV) infection is associated with tuberculosis (TB) disease. This study aimed to assess the relationship between the dynamics of HCMV markers and TB disease in people with HIV (PWH). Methods In a case-control study nested within a Thai HIV cohort, stored samples from PWH who diagnosed with TB disease after ART (cases) and TB-negative controls matched 1:2 on ART duration. HCMV DNA, HCMV IgM, and IgG were measured at 3 timepoints: (1) 6-24 months before TB diagnosis (pre-TB visit), (2) at TB diagnosis (TB visit), and (3) 6-24 months after TB diagnosis (post-TB visit). Results We enrolled 34 TB cases and 68 controls, the majority of whom were male (56% vs 60%). At the pre-TB visit, all participants were IgG seropositive, and there were no significant differences in the proportion with HCMV viremia or in HCMV IgM or IgG levels. At TB diagnosis visit, we found lower median CD4 counts in cases compared with controls (606 (IQR: 449-864) vs 427 (IQR:213-611); p 0.001). The proportion of HCMV viremia was higher among TB cases (34.5%) compared with controls (13.8%, p = 0.028). HCMV IgM geometric mean concentration was higher in cases (0.17 vs 0.12 AU/mL; geometric mean ratio 1.38, 95% CI 1.01-1.87; p = 0.039). At post-TB visit, HCMV viremia remained more frequent in cases (31.8% vs 4.5%), p = 0.006) Conclusion HCMV viremia and serology measured 6-24 months before TB diagnosis in cases did not differ from those in matched controls. At TB diagnosis, PWH with TB had higher proportion of HCMV viremia and higher GMC of HCMV IgM, possibly reflecting HCMV reactivation due to TB disease.
Gatechompol et al. (Fri,) studied this question.