Asthma-Chronic Obstructive Pulmonary Diseases Overlap Syndrome Increases the Risk of Incident Tuberculosis: A National Cohort Study

doi:10.1371/journal.pone.0159012

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Title:	Asthma-Chronic Obstructive Pulmonary Diseases Overlap Syndrome Increases the Risk of Incident Tuberculosis: A National Cohort Study
Authors:	Yeh, Jun-Jun Wang, Yu-Chiao Kao, Chia-Hung
Contributors:	Chia Yi Christian Hosp, Ditmanson Med Fdn Chia Nan Univ Pharm & Sci Meiho Univ China Med Univ Hosp, Management Off Hlth Data China Med Univ, Coll Med China Med Univ, Coll Med, Grad Inst Clin Med Sci China Med Univ Hosp, Dept Nucl Med China Med Univ Hosp, PET Ctr
Keywords:	copd overlap inhaled corticosteroids syndrome acos lung-disease taiwan exacerbations tiotropium phenotypes stay gold
Date:	2016-07
Issue Date:	2018-01-18 11:41:03 (UTC+8)
Publisher:	Public Library Science
Abstract:	Purpose The association between asthma-chronic obstructive pulmonary diseases (COPD) overlap syndrome (ACOS) and tuberculosis (TB) has yet to be studied. Methods The newly diagnosed TB patients (age > 20 y) treated from January 2000 to December 2008 were included (ACOS cohort, n = 10 751; non-ACOS cohort, n = 42 966). The non-ACOS cohort involved patients with confirmed absence of ACOS. We calculated incidence rate ratios (IRRs) for TB in the ACOS and non-ACOS cohorts by using poisson regression analysis. Cox proportional hazards regression models were used to determine the adjusted HR (aHR) for TB in the ACOS cohort compared with the non-ACOS cohort. Results The aHR for TB was 2.41 (95% confidence interval [CI], 2.19-2.66) in the ACOS cohort. The TB risk was significantly higher in the ACOS cohort than in the non-ACOS cohort when stratified by age, sex, comorbidities, and atopy. Within the ACOS cohort, the aHR was higher among patients receiving SABAs+ SAMAs, LABAs+ LAMAs, and ICSs (aHR [95% CI]: 3.06 [2.75-3.41], 3.68 [2.93-4.61], and 2.79 [1.25-6.22], respectively; all P <.05). Furthermore, patients with more than 15 outpatient visits and hospitalizations per year demonstrated the highest aHR (8.09; 95% CI, 6.85-9.56). Conclusions ACOS cohort potentially develop incident TB, regardless of the age, sex, comorbidities and atopy; even without receiving the inhalers. This risk is higher, especially in the ACOS cohort have a high frequency of medical services or receiving the inhalers such as SABAs +SAMAs, LABAs+LAMAs and ICSs.
Relation:	Plos One, v.11 n.7, e0159012
Appears in Collections:	[Dept. of Childhood Education and Nursery] Periodical Articles

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