Extrathoracic tuberculosis lymphadenitis in adult HIV seronegative patients: a population-based analysis in Houston, Texas, USA
Abstract:OBJECTIVE: To evaluate the covariates associated with extrathoracic tuberculosis lymphadenitis (ETBL) among adult HIV-seronegative patients.
METHODS: Enrollees were interviewed for TB risk assessment, their medical records were reviewed, and their Mycobacterium tuberculosis isolates underwent molecular characterization. Between 1 October 1995 and 30 September 1999, HIV-negative patients with ETBL were compared with other HIV-negative TB patients.
RESULTS: We identified 73 ETBL cases (5%) out of a total of 1371 adult HIV-negative enrollees. Significant variables predicting ETBL in the univariate analysis included age <45 years, female sex, Asian ethnicity, foreign birth, BCG vaccination, and infection with a M. tuberculosis isolate identified in major genetic group 1. Further analysis by birth country revealed increased ETBL risk for persons from countries other than the Americas and with a TB incidence >25 per 100000 per year. The multivariate model demonstrated increased risk for ETBL for patients of female sex (OR = 2.6, P < 0.01) and birth in Africa or South-east Asia (OR = 4.8; P = 0.03 and OR = 33.6; P = 0.01, respectively).
CONCLUSIONS: In adult HIV-negative patients, ETBL occurs more frequently in females and in immigrants from countries other than the Americas; persons from India, South-east Asia and the Eastern Mediterranean exhibited the highest risk among these regions.
Document Type: Regular Paper
Affiliations: 1: Department of Medicine, Infectious Disease Section, Baylor College of Medicine, Houston, Texas, USA 2: Department of Pathology, Infectious Disease Section, Baylor College of Medicine, Houston, Texas, USA 3: Rocky Mountain Laboratories, National Institutes for Health, National Institute of Allergy and Infectious Diseases (NIAID), Hamilton, Minnesota, USA 4: Departments of Medicine and Pathology, Infectious Disease Section, Baylor College of Medicine, Houston, Texas, USA
Publication date: October 1, 2003
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