Increased risk of pulmonary tuberculosis in patients with previous non-tuberculous mycobacterial disease

doi:10.5588/ijtld.12.0675

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標題:	Increased risk of pulmonary tuberculosis in patients with previous non-tuberculous mycobacterial disease
作者:	Hsing, S-C. Weng, S-F. Cheng, K-C. Shieh, J-M. Chen, C-H. Chiang, S-R. Wang, J-J.
貢獻者:	醫務管理系
關鍵字:	Tuberculosis Ntm Disease Human Immunodeficiency Virus Population-Based Cohort Study
日期:	2013-07
上傳時間:	2014-05-26 10:46:54 (UTC+8)
出版者:	Int Union Against Tuberculosis Lung Disease (I U A T L D)
摘要:	OBJECTIVE: To investigate whether or not there is an increased risk of pulmonary tuberculosis (PTB) after non-tuberculous mycobacterial (NTM) 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 (HEV) 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.
關聯:	International Journal of Tuberculosis And Lung Disease, v.17 n.7, pp.928-933
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