Latent Tuberculosis Infection and Subclinical Coronary Atherosclerosis in Peru and Uganda

Moises A. Huaman, Carlo N. De Cecco, Marcio S. Bittencourt, Eduardo Ticona, Cissy Kityo, Isabel Ballena, Sophie Nalukwago, Rashidah Nazzinda, Cesar Ticona, Ruben Azañero, Bin Zhang, Carey Farquhar, Thomas R. Hawn, Timothy R. Sterling, Carl J. Fichtenbaum, Chris T. Longenecker

Research output: Contribution to journalArticlepeer-review

19 Scopus citations


Background: Tuberculosis (TB) has been linked to an increased risk of atherosclerotic cardiovascular disease (ASCVD). We assessed whether latent TB infection (LTBI) is associated with subclinical coronary atherosclerosis in 2 TB-prevalent areas. Methods: We analyzed cross-sectional data from studies conducted in Lima, Peru, and Kampala, Uganda. Individuals ≥40 years old were included. We excluded persons with known history of ASCVD events or active TB. Participants underwent QuantiFERON-TB (QFT) testing to define LTBI and computed tomography angiography to examine coronary atherosclerosis. A Coronary Artery Disease-Reporting Data System (CAD-RADS) score ≥3 defined obstructive CAD (plaque causing ≥50% stenosis). Results: 113 and 91 persons with and without LTBI, respectively, were included. There were no significant differences between LTBI and non-LTBI participants in terms of age (median [interquartile range]; 56 [51-62] vs 55 [49-64] years; P=.829), male sex (38% vs 42%; P=.519), or 10-year ASCVD risk scores (7.1 [3.2-11.7] vs 6.1 [2.8-1.8]; P=.533). CAD prevalence (any plaque) was similar between groups (29% vs 24%; P=.421). Obstructive CAD was present in 9% of LTBI and 3% of non-LTBI individuals (P=.095). LTBI was associated with obstructive CAD after adjusting for ASCVD risk score, HIV status, and study site (adjusted OR, 4.96; 95% CI, 1.05-23.44; P=.043). Quantitative QFT TB antigen minus Nil interferon-γresponses were associated with obstructive CAD (adjusted OR, 1.2; 95% CI, 1.03-1.41; P=.022). Conclusions: LTBI was independently associated with an increased likelihood of subclinical obstructive CAD. Our data indicate that LTBI is a nontraditional correlate of ASCVD risk.

Original languageEnglish
Pages (from-to)E3384-E3390
JournalClinical Infectious Diseases
Issue number9
StatePublished - 1 Nov 2021

Bibliographical note

Publisher Copyright:
© 2021 The Author(s) 2021. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail:


  • atherosclerosis
  • coronary artery disease
  • coronary computed tomography angiography
  • latent tuberculosis infection


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