title: Long-term risk of tuberculosis in haematopoietic stem cell transplant recipients: a 10-year nationwide study.
abstract: BACKGROUND
  Tuberculosis (TB) is a serious problem for patients undergoing haematopoietic stem cell transplantation (HSCT) in TB-endemic areas; however, data on these patients are limited.
  
  
  METHODS
  We obtained data on 2040 HSCT recipients from the Registry of Catastrophic Illness in Taiwan from 1997 to 2006. We also obtained data on age-, sex- and enrolment date-matched controls from the Longitudinal Health Insurance Database. The cumulative incidence of active TB in HSCT recipients and controls and risk factors for TB were analysed.
  
  
  RESULTS
  Among 2040 HSCT recipients identified, 39 (1.9%) had newly diagnosed TB. The incidence rate was 688 per 100 000 person-years. The 10-year cumulative TB incidence was respectively 3.52% and 0.38% in HSCT recipients and controls (P < 0.001). HSCT was an independent risk factor for TB compared with matched controls. Among post-HSCT patients, independent risk factors for TB included age ⩾18 years and allogeneic recipients with graft-versus-host disease (GVHD). Post-HSCT patients with subsequent TB had a higher mortality rate than those without TB (P < 0.001).
  
  
  CONCLUSIONS
  HSCT is associated with an increased risk of TB in endemic regions. Older age and development of chronic GVHD are independent predictors of late onset active TB in HSCT recipients.
authors.affiliation: Division of Infectious Disease, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan; School of Medicine, National Yang-Ming University, Taipei, Taiwan.
authors.forename: W-C
authors.initials: WC
authors.lastname: Fan
authors.affiliation: Division of Hematology and Oncology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan; School of Medicine, Institute of Public Health, National Yang-Ming University, Taipei, Taiwan.
authors.forename: C-J
authors.initials: CJ
authors.lastname: Liu
authors.affiliation: Division of Hematology and Oncology, Department of Medicine, Kaoshiung Veterans General Hospital, Kaohsiung City, Taiwan; School of Medicine, National Yang-Ming University, Taipei, Taiwan.
authors.forename: Y-C
authors.initials: YC
authors.lastname: Hong
authors.affiliation: Department of Chest Medicine, Taipei Veterans General Hospital, Taipei, Taiwan; Institute of Clinical Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan.
authors.forename: J-Y
authors.initials: JY
authors.lastname: Feng
authors.affiliation: School of Medicine, National Yang-Ming University, Taipei, , Taiwan; Department of Chest Medicine, Taipei Veterans General Hospital, Taipei, Taiwan.
authors.forename: W-J
authors.initials: WJ
authors.lastname: Su
authors.affiliation: School of Medicine, National Yang-Ming University, Taipei, , Taiwan; Division of Hematology and Oncology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan.
authors.forename: S-H
authors.initials: SH
authors.lastname: Chien
authors.affiliation: School of Medicine, National Yang-Ming University, Taipei, , Taiwan; Department of Family Medicine, Taipei Veterans General Hospital, Taipei, Taiwan.
authors.forename: T-J
authors.initials: TJ
authors.lastname: Chen
authors.affiliation: Division of Cardiology, Department of Medicine, Da-Chien General Hospital, Miaoli, , Taiwan; Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan; Cardiovascular Research Center, National Yang-Ming University, Taipei, Taiwan; Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan.
authors.forename: C-H
authors.initials: CH
authors.lastname: Chiang
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D015897:Comorbidity; D005260:Female; D005500:Follow-Up Studies; D006086:Graft vs Host Disease / Q000188:drug therapy / Q000453:epidemiology* / Q000382:microbiology; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects*; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D013624:Taiwan / Q000453:epidemiology; D066027:Transplant Recipients; D014376:Tuberculosis / Q000453:epidemiology*; D055815:Young Adult
chemical_list: D007166:Immunosuppressive Agents