Pulmonary tuberculosis and delay in anti-tuberculous treatment are important risk factors for chronic obstructive pulmonary disease.
OBJECTIVE
Tuberculosis (TB) remains the leading cause of death among infectious diseases worldwide. It has been suggested as an important risk factor of chronic obstructive pulmonary disease (COPD), which is also a major cause of morbidity and mortality. This study investigated the impact of pulmonary TB and anti-TB treatment on the risk of developing COPD.


METHODS
This cohort study used the National Health Insurance Database of Taiwan, particularly the Longitudinal Health Insurance Database 2005 to obtain 3,176 pulmonary TB cases and 15,880 control subjects matched in age, sex, and timing of entering the database.


METHODS
Hazard ratios of potential risk factors of COPD, especially pulmonary TB and anti-TB treatment.


RESULTS
The mean age of pulmonary TB cases was 51.9±19.2. The interval between the initial study date and commencement of anti-TB treatment (delay in anti-TB treatment) was 75.8±65.4 days. Independent risk factors for developing COPD were age, male, low income, and history of pulmonary TB (hazard ratio 2.054 [1.768-2.387]), while diabetes mellitus was protective. The impact of TB persisted for six years after TB diagnosis and was significant in women and subjects aged >70 years. Among TB patients, delay in anti-TB treatment had a dose-response relationship with the risk of developing COPD.


CONCLUSIONS
Some cases of COPD may be preventable by controlling the TB epidemic, early TB diagnosis, and prompt initiation of appropriate anti-TB treatment. Follow-up care and early intervention for COPD may be necessary for treated TB patients.
Graduate Institute of Biomedical Electronics and Bioinformatics, National Taiwan University, Taipei, Taiwan.
Chih-Hsin
CH
Lee
Ming-Chia
MC
Lee
Hsien-Ho
HH
Lin
Chin-Chung
CC
Shu
Jann-Yuan
JY
Wang
Li-Na
LN
Lee
Kun-Mao
KM
Chao
D000328:Adult; D017668:Age of Onset; D000368:Aged; D000995:Antitubercular Agents / Q000627:therapeutic use*; D015331:Cohort Studies; D061345:Early Medical Intervention; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D029424:Pulmonary Disease, Chronic Obstructive / Q000453:epidemiology / Q000209:etiology*; D012307:Risk Factors; D014397:Tuberculosis, Pulmonary / Q000150:complications* / Q000188:drug therapy*
D000995:Antitubercular Agents