Cirrhosis as a risk factor for tuberculosis infection--a nationwide longitudinal study in Taiwan.
Tuberculosis (TB) and cirrhosis of the liver are both endemic in many regions of the world. However, the risk of TB in cirrhotic patients has rarely been investigated. A nationwide cohort study was conducted to elucidate and characterize the association between cirrhosis and TB in Taiwan. The study included 41,076 cirrhotic patients and 204,244 noncirrhotic controls from 1998 through 2007. Cirrhotic and noncirrhotic subjects were matched 1:5 on age and sex. A total of 957 of 41,076 (2.32%) cirrhotic patients developed TB, yielding a rate that was significantly higher than that of the 955 of 204,244 (0.46%) noncirrhotic patients (P < 0.001). In a Cox regression model adjusted for age, sex, and underlying medical disorders, a significantly higher active TB rate was maintained for cirrhotic patients compared with their noncirrhotic counterparts (adjusted hazard ratio = 3.55, 95% confidence interval (CI): 3.08, 4.09; P < 0.001). Alcoholism and hepatitis C infection were associated with significantly higher TB risk with adjust hazard ratios of 2.18 (95% CI: 1.86, 4.09; P < 0.001) and 1.18 (95% CI: 1.02, 1.30; P < 0.001), respectively. Cirrhotic patients have a greater risk of TB than noncirrhotic patients, particularly those with alcoholism and hepatitis C infection.
Yi-Ting
YT
Lin
Ping-Hsun
PH
Wu
Chun-Yu
CY
Lin
Ming-Yen
MY
Lin
Hung-Yi
HY
Chuang
Jee-Fu
JF
Huang
Ming-Lung
ML
Yu
Wan-Long
WL
Chuang
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000437:Alcoholism / Q000150:complications; D016022:Case-Control Studies; D005260:Female; D006526:Hepatitis C / Q000150:complications; D006801:Humans; D053208:Kaplan-Meier Estimate; D008103:Liver Cirrhosis / Q000150:complications* / Q000453:epidemiology; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D016016:Proportional Hazards Models; D012307:Risk Factors; D012737:Sex Factors; D013624:Taiwan / Q000453:epidemiology; D014397:Tuberculosis, Pulmonary / Q000453:epidemiology / Q000209:etiology*; D055815:Young Adult
Taiwan National Health Insurance Research Database; liver cirrhosis; risk factor; tuberculosis