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Increased risk of pulmonary tuberculosis in patients with previous non-tuberculous mycobacterial disease
DESIGN: A retrospective cohort study of 212 NTM patients and 4240 control cases.
RESULTS: Patients with previous NTM disease had a significantly higher incidence of PTB than controls (incidence rate ratio [IRR] 14.74, 95%CI 8.71–24.94, P < 0.0001). Cox's proportional hazards analysis yielded an adjusted hazards ratio (aHR) of 10.15 (95%CI 5.67–18.17, P < 0.05) for NTM-associated PTB. The majority of the PTB cases (17/23, 73.9%) were diagnosed within 6 months after the diagnosis of NTM disease. Older age (≥65 years, aHR 4.45, 95%CI 1.94–10.22, P < 0.05), male sex (aHR 1.75, 95%CI 1.01–3.13, P < 0.05), human immunodeficiency virus (HIV) infection (aHR 12.49, 95%CI 3.20–48.79, P < 0.05) and chronic obstructive pulmonary disease (aHR 4.46, 95%CI 2.19–9.10, P < 0.05) were independent risk factors for developing PTB after NTM disease. The cumulative incidence of PTB in patients with previous NTM disease was significantly higher than in controls (P < 0.0001, Kaplan-Meier analysis). However, there was no significant difference in the survival rates in the two cohorts.
CONCLUSION: Increased PTB prevalence after NTM disease was demonstrated. HIV infection was the greatest independent risk factor for subsequent development of PTB.
Keywords: NTM disease; human immunodeficiency virus; population-based cohort study; tuberculosis
Document Type: Research Article
Affiliations: 1: Department of Respiratory Care Section, Chi Mei Medical Center, Tainan, Taiwan; and College of Health Sciences, Chang Jung Christian University, Tainan, Taiwan 2: Department of Medical Research, Chi Mei Medical Center, Tainan, Taiwan; and Hospital and Health Care Administration, Chia Nan University of Pharmacy and Science, Tainan, Taiwan 3: Department of Internal Medicine, Chi Mei Medical Center, Tainan, Taiwan; Department of Safety Health and Environment, Chung Hwa University of Medical Technology, Tainan, Taiwan; and Department of Medicine, National Defense Medical Center, Taipei, Taiwan 4: College of Health Sciences, Chang Jung Christian University, Tainan, Taiwan; Department of Internal Medicine, Chi Mei Medical Center, Tainan, Taiwan; and Department of General Education, Chia Nan University of Pharmacy and Science, Tainan, Taiwan 5: Department of Internal Medicine, En Chu Kong Hospital, New Taipei City, Taiwan 6: Department of Medical Research, Chi Mei Medical Center, Tainan, Taiwan
Publication date: 01 July 2013
The International Journal of Tuberculosis and Lung Disease (IJTLD) is for clinical research and epidemiological studies on lung health, including articles on TB, TB-HIV and respiratory diseases such as COVID-19, asthma, COPD, child lung health and the hazards of tobacco and air pollution. Individuals and institutes can subscribe to the IJTLD online or in print – simply email us at [email protected] for details.
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