Smoking adversely affects treatment response, outcome and relapse in tuberculosis
Autor: | Chi C. Leung, Cheuk Ming Tam, Shan S. Huang, Eric C.C. Leung, Shuk Nor Lee, Kwok Chiu Chang, Wing S. Law, Ronald K.F. Au, Lai B. Tai, Chi K. Chan, Wing Wai Yew |
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Rok vydání: | 2014 |
Předmět: |
Pulmonary and Respiratory Medicine
Adult Male medicine.medical_specialty Tuberculosis medicine.medical_treatment Antitubercular Agents Recurrence Risk Factors Internal medicine medicine Humans Registries Tuberculosis Pulmonary Aged Chemotherapy Transmission (medicine) business.industry Incidence (epidemiology) Incidence Hazard ratio Smoking Sputum Mycobacterium tuberculosis Middle Aged medicine.disease respiratory tract diseases Surgery Treatment Outcome Attributable risk Smoking cessation Hong Kong Female Smoking Cessation medicine.symptom business Follow-Up Studies |
Zdroj: | The European respiratory journal. 45(3) |
ISSN: | 1399-3003 |
Popis: | The impact of smoking on tuberculosis outcome was evaluated in a territory-wide treatment programme.16 345 consecutive patients undergoing chemotherapy for active tuberculosis in government chest clinics in Hong Kong from 2001 to 2003 were followed up prospectively for 2 years for treatment outcome and subsequently tracked through the territory-wide tuberculosis notification registry for relapse until the end of 2012.Smoking was associated with more extensive lung disease, lung cavitation and positive sputum smear and culture at the baseline. In both current smokers and ex-smokers, sputum smears and cultures were significantly more likely to remain positive after 2 months of treatment. Both categories of smokers were significantly less likely to achieve cure or treatment completion within 2 years. Overall, 16.7% of unsuccessful treatment outcomes were attributable to smoking, with the key contributor being default in current smokers and death in ex-smokers. Among successful treatment completers, there was a clear gradient (hazard ratios of 1.00, 1.33 and 1.63) of relapse risk from never-smokers to ex-smokers and current smokers, with an overall population attributable risk of 19.4% (current smokers: 12.2%; ex-smokers: 7.2%).Smoking adversely affects baseline disease severity, bacteriological response, treatment outcome and relapse in tuberculosis. Smoking cessation likely reduces relapse and secondary transmission. |
Databáze: | OpenAIRE |
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