Solid-organ malignancy as a risk factor for tuberculosis
| Autor: | Sung Joon Park, Sang Min Lee, Dong Yeob Ha, Young Soo Shim, Yun Kwan Ro, Jae-Joon Yim, Chang Ho Jeon, Youngwhan Kim, S. K. Han, Seung Sik Hwang, Chang Hoon Lee, Hye Ryoun Kim, Chul Gyu Yoo |
|---|---|
| Rok vydání: | 2008 |
| Předmět: |
Adult
Male Pulmonary and Respiratory Medicine medicine.medical_specialty Lung Neoplasms Tuberculosis Adolescent Antineoplastic Agents Breast Neoplasms Malignancy Anticancer chemotherapy Cohort Studies Drug Therapy Risk Factors Stomach Neoplasms medicine Humans Risk factor Tuberculosis Pulmonary health care economics and organizations Aged Retrospective Studies Aged 80 and over Immunosuppression Therapy business.industry Liver Neoplasms virus diseases Retrospective cohort study Middle Aged medicine.disease eye diseases Surgery Case-Control Studies Family medicine Colonic Neoplasms Regression Analysis Chronic renal failure Female business Cohort study |
| Zdroj: | Respirology. 13:413-419 |
| ISSN: | 1440-1843 1323-7799 |
| DOI: | 10.1111/j.1440-1843.2008.01282.x |
| Popis: | The effective control of tuberculosis (TB) requires that people at high risk for the reactivation of TB are identified. Haematological malignancy has been shown to be a risk factor for the development of TB, either through immune suppression by the tumour or through the effects of chemotherapy. This study assessed the hypothesis that solid-organ malignancy is a risk factor for the development of TB.A retrospective cohort study was performed to determine the incidence of TB in patients with solid-organ malignancy and in control subjects without malignancy. Risk factors for the development of TB among patients with cancer were also assessed.The study recruited 1809 cases with cancer and 1809 control subjects and followed them for 3 years. The incidence of active TB per 1000 person-years was 3.07 in patients with cancer and 0.77 in controls (P = 0.009). Compared with the control group, patients with cancer had an increased risk of developing TB (incidence rate ratio (IRR) 4.69, 95% CI: 1.52-14.46). Proportional hazards regression analysis showed that the risk factors for development of TB were chronic renal failure (IRR 9.91, 95% CI: 1.17-83.60), old healed TB on CXR (IRR 45.05, 95% CI: 5.74-353.88), and anticancer chemotherapy (IRR 4.32, 95% CI: 1.10-16.89). An interaction between old healed TB and anticancer chemotherapy was observed.These findings indicate that immune suppression by cancer or by anticancer chemotherapy increases vulnerability to reactivation of TB, especially in cancer patients with old healed TB. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|
Plný text