title: Increased risk of pulmonary tuberculosis in patients with gastroesophageal reflux disease.
abstract: BACKGROUND
  Previous studies have suggested a close correlation between gastroesophageal reflux disease (GERD) and various respiratory disorders. However, the association between GERD and tuberculosis (TB) remains unexplored.
  
  
  METHODS
  Using data retrieved from Taiwan's National Health Insurance Research Database from 2000 to 2009, this longitudinal nationwide cohort study included a total of 63,930 patients with GERD and controls matched by age, sex and comorbidities. Risk factors associated with the development of pulmonary TB (PTB) were investigated.
  
  
  RESULTS
  Active PTB was documented in 65 (0.20%) patients with GERD and 41 (0.13%) matched cohorts within 1 year of GERD diagnosis. The incidence rate of PTB in the GERD group and the matched cohort was respectively 24.1 and 15.2 cases per 10,000 person-years. In multivariate analysis, GERD was an independent risk factor for PTB (adjusted HR 1.63, 95%CI 1.10-2.40, P = 0.015). Among patients with GERD, independent predictors for PTB included older age, male sex, chronic obstructive pulmonary disease, asthma and exposure to proton pump inhibitors (PPIs).
  
  
  CONCLUSIONS
  Patients with GERD have a significantly increased risk of PTB within 1 year of GERD diagnosis. Exposure to PPIs is an independent predictor for PTB among patients with GERD.
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: School of Medicine, National Yang-Ming University, Taipei, Taiwan; Division of Nephrology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan.
authors.forename: S-M
authors.initials: SM
authors.lastname: Ou
authors.affiliation: School of Medicine, National Yang-Ming University, Taipei, Taiwan; 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; Cancer Center, Taipei Veterans General Hospital, Taipei, Taiwan; Institute of Public Health, National Yang-Ming University, Taipei, Taiwan.
authors.forename: Y-W
authors.initials: YW
authors.lastname: Hu
authors.affiliation: Department of Family Medicine, Taipei Veterans General Hospital, Taipei, Taiwan.
authors.forename: C-M
authors.initials: CM
authors.lastname: Yeh
authors.affiliation: School of Medicine, National Yang-Ming University, Taipei, Taiwan; Department of Chest Medicine, Taipei Veterans General Hospital Taipei, Taiwan.
authors.forename: V Y-F
authors.initials: VY
authors.lastname: Su
authors.affiliation: School of Medicine, National Yang-Ming University, Taipei, Taiwan; Department of Psychiatry, Kaoshiung Veterans General Hospital, Kaoshiung, Taiwan.
authors.forename: L-Y
authors.initials: LY
authors.lastname: Hu
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 Chest Medicine, Taipei Veterans General Hospital Taipei, Taiwan.
authors.forename: W-J
authors.initials: WJ
authors.lastname: Su
authors.affiliation: Department of Family Medicine, Taipei Veterans General Hospital, Taipei, Taiwan.
authors.forename: T-J
authors.initials: TJ
authors.lastname: Chen
authors.affiliation: School of Medicine, National Yang-Ming University, Taipei, Taiwan; Institute of Public Health, National Yang-Ming University, Taipei, Taiwan; Division of Hematology and Oncology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan.
authors.forename: C-J
authors.initials: CJ
authors.lastname: Liu
mesh_terms: D000328:Adult; D016022:Case-Control Studies; D016009:Chi-Square Distribution; D015897:Comorbidity; D016208:Databases, Factual; D005260:Female; D005764:Gastroesophageal Reflux / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology*; D006635:Histamine H2 Antagonists / Q000627:therapeutic use; D006801:Humans; D015994:Incidence; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016016:Proportional Hazards Models; D054328:Proton Pump Inhibitors / Q000627:therapeutic use; D018570:Risk Assessment; D012307:Risk Factors; D013624:Taiwan / Q000453:epidemiology; D014397:Tuberculosis, Pulmonary / Q000175:diagnosis / Q000453:epidemiology* / Q000382:microbiology
chemical_list: D006635:Histamine H2 Antagonists; D054328:Proton Pump Inhibitors