Prevalence and risk factors of active tuberculosis in patients with rheumatic diseases: a multi-center, cross-sectional study in China

Liu, Xiaoqing; Zhang, Lifan; Zhang, Fengchun; Zeng, Xiaofeng; Zhao, Yan; Wang, Qian; Liu, Shengyun; Zuo, Xiaoxia; Zhang, Zhiyi; Wu, Huaxiang; Chen, Sheng; Li, Hongbin; Zhu, Ping; Wu, Lijun; Qi, Wencheng; Liu, Yi; Zhang, Miaojia; Liu, Huaxiang; Xu, Dong; Zheng, Wenjie; Zhang, Yueqiu; Shi, Xiaochun; Han, Ling; Zhou, Yujun; Zhao, Yongqiang; Wang, Wenwen; Li, Ting; Tie, Ning; Zhang, Kui; Luo, Cainan; Gong, Boqi; Zhao, Yi; Lv, Chengyin; Song, Lijun; Wu, Qingjun; Fei, Yunyun; Zhang, Lei; Luo, Hui; Sun, Jiaying; Xue, Jing; Gu, Liyang; Wang, Jing; Han, Qing; Yimaity, Kuerbanjiang; Zhou, Jiaxin; Zhao, Lu; Bian, Sainan; Qi, Wufang; Li, Yanhong; Zhu, Yujing; Han, Huijun; Liao, Susu; Liu, Gaifen

doi:10.1080/22221751.2021.2004864

Cited by 13 publications

(10 citation statements)

References 31 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Among 27 studies, nine were from China, 7,8,11,12,[20][21][22][23][24] and the rest were in various countries 1,[4][5][6]9,[14][15][16][25][26][27][28][29][30][31][32][33][34] (Table 1). Twenty-five studies reported prevalence of TB disease, [4][5][6][7][8][9]11,12,[14][15][16]20,21,[23][24][25][26][27][29][30][31][32][33][34] whereas three studies ...…”

Section: Search Results and Study Characteristicsmentioning

confidence: 99%

“…We grouped the country origin based on WHO global list of high TB burden countries. 36 There were 17 studies from 5 high TB burden countries [6][7][8]11,12,15,[20][21][22][23][24][25]27,29,[31][32][33] and 8 studies from 7 non-high TB burden countries. 4,5,9,14,16,26,30,34 There was an apparent higher prevalence of TB disease in high TB burden than non-high TB burden countries: active TB (5% vs 2%), pulmonary TB (3% vs 1%), extrapulmonary TB (3% vs 0%), and disseminated TB (1% vs 0%).…”

Section: Search Results and Study Characteristicsmentioning

confidence: 99%

“…Among 27 studies, nine were from China, 7,8,11,12,20–24 and the rest were in various countries 1,4–6,9,14–16,25–34 (Table 1). Twenty-five studies reported prevalence of TB disease, 4–9,11,12,14–16,20,21,23–27,29–34 whereas three studies reported the prevalence of TB infection.…”

Section: Resultsmentioning

confidence: 99%

See 2 more Smart Citations

Global tuberculosis disease and infection in systemic lupus erythematosus patients: A systematic review and meta-analysis

Darmawan,

Liman,

Wibowo

et al. 2024

Lupus

View full text Add to dashboard Cite

Background Tuberculosis (TB) is one of the most common infections among systemic lupus erythematosus (SLE) patients. We aimed to evaluate the global prevalence of TB infection and disease, its type, and medication risk factors in SLE patients. Methods We searched PubMed, Science Direct, EBSCO, and Web of Science databases from inception to April 30, 2023, and included studies assessing TB among SLE patients. We estimated the prevalence of TB disease (including type of TB disease), TB infection, and SLE medication as TB risk factors. Meta-analysis was performed using Stata 14.2 and Review Manager 5.3. Results Twenty-seven studies met the eligibility criteria. The global prevalence of TB disease was 4% (95% confidence interval (CI): 3–4%, n = 25) and TB infection was 18% (95% CI: 10–26%, n = 3). The pooled prevalence of pulmonary TB, extrapulmonary TB, and disseminated TB were 2% (95% CI: 2–3%, n = 20), 1% (95% CI: 1–2%, n = 17), and 1% (95% CI: 0–1%, n = 6), respectively. The 1-year cumulative glucocorticoid (GC) dose in SLE patients contracting TB was higher than in those without TB, having a mean difference of 2.56 (95% CI: 0.22–4.91, p < .00001, n = 3). The odd ratio of TB was 2.11 (95% CI: 1.01–4.41, p = .05, n = 3) in SLE patients receiving methylprednisolone (MP) pulse therapy as compared to those without MP pulse therapy. Other immunosuppressive agents were not significantly associated with TB. Conclusion TB prevalence in SLE was relatively high and associated with GC. Awareness of TB and lowering GC dose are warranted to alleviate the TB burden in SLE.

show abstract

Section: Search Results and Study Characteristicsmentioning

confidence: 99%

Section: Search Results and Study Characteristicsmentioning

confidence: 99%

See 1 more Smart Citation

Global tuberculosis disease and infection in systemic lupus erythematosus patients: A systematic review and meta-analysis

Darmawan,

Liman,

Wibowo

et al. 2024

Lupus

View full text Add to dashboard Cite

show abstract

“…A few systematic studies have been reported on rheumatic diseases concomitant with TB; however, most were singledisease studies and included few observational indicators (13)(14)(15)(16)(17)(18)(19). In this study, we investigated the clinical manifestations and influencing factors of TB among patients with various common rheumatic diseases.…”

Section: Introductionmentioning

confidence: 99%

Clinical characteristics and related influencing factors of common rheumatic diseases concomitant with tuberculosis

Tang

Chen

Han

et al. 2023

Front. Public Health

View full text Add to dashboard Cite

ObjectiveTo explore the clinical characteristics and risk factors of common systemic rheumatism concomitant with tuberculosis (TB).MethodsA total of 3,906 patients of RA, SLE, and SS diagnosed in the People's Hospital of Sichuan Province from January 2007 to January 2017 were collected. One hundred and five patients with TB were included as TB group, including 42 RA, 41 SLE, and 22 SS patients. In the non-TB group, 84 RA, 82 SLE, and 44 SS patients were randomly selected during the same period.ResultsFever was the most common symptom among RA, SLE, and SS patients with TB, accounting for 83.3%, 92.7%, and 68.2%, respectively. Cough, weight loss or fatigue were the next common. RA patients with TB were mostly pulmonary TB (PTB), accounting for 64.3%. The proportion of PTB for SLE and SS were 46.3%, 59.01%, respectively. In TB group, 59% RA, 57% SLE, and 62% SS with PTB had two or more chest CT findings. There were 48 TB cases received both Interferon Gamma Release Assay (IGRA) and Tuberculin skin test (TST) with positive rates of 91.8%, 45.8%, respectively. The daily average dose of glucocorticoids within 1 year in TB group was higher than that in non-TB group of SLE patients, lower counts of CD4+ T cell count were found in TB group (P < 0.05), while no such differences were found in RA and SS patients.ConclusionRA patients with TB are mainly pulmonary TB. For SLE and SS patients, the chance of PTB and extrapulmonary tuberculosis is similar. Daily average dose of glucocorticoids within 1 year may be a common risk factor for RA, SLE and SS patients developing TB. Decreased CD4+ T cell count may also be a risk factor for SLE patients with TB. Symptoms of RA, SLE, SS with TB, are similar with the primary disease or other infection. It is recommended to conduct both TST and IGRA to help diagnose TB.

show abstract

“…In recent years, studies have reported inconsistent results regarding the specific incidence and prevalence of SLE-TB (10)(11)(12)(13). Therefore, a contemporary and comprehensive evaluation and update of the SLE-TB epidemiology data worldwide is necessary as it will provide a theoretical basis for TB screening and preventive treatment in SLE patients.…”

Section: Introductionmentioning

confidence: 99%

Incidence and prevalence of tuberculosis in systemic lupus erythematosus patients: A systematic review and meta-analysis

et al. 2022

View full text Add to dashboard Cite

BackgroundSystemic lupus erythematosus (SLE) patients are particularly susceptible to infections, such as pulmonary tuberculosis (PTB) and extrapulmonary tuberculosis (EPTB). This meta-analysis aimed to determine the incidence and prevalence of tuberculosis (TB) in SLE patients.MethodsThe Web of Science, PubMed, Cochrane Library, and Chinese National Knowledge Infrastructure databases were searched for articles of relevant studies published from the dates the databases were established until April 30, 2022. The I2 statistic and Q test were used to evaluate heterogeneity among the analysed studies. Random-effects models were utilised and subgroup analyses were conducted for analysis of the study data.ResultsA total of 35 studies with 46,327 SLE patients were eligible for analysis. The incidence and prevalence of TB among the SLE patients were 1.16 per 100 person-years (95% confidence interval (CI): 0.69-1.93) and 3.59% (95% CI: 2.57%-5.02%), respectively. The pooled prevalence of SLE-PTB and SLE-EPTB was 2.46% (95% CI: 1.73%-3.51%) and 1.42% (95% CI: 0.98%-2.06%), respectively. Subgroup analyses showed that the incidence of SLE-TB was higher in Africa and in countries with a high TB burden than in countries with a low TB burden. The prevalence of SLE-TB was elevated in Asia, in patients taking a mean daily dose of glucocorticoids ≥20 mg, in studies with small sample sizes (n <1000) and ended before 2001.ConclusionsThe available evidence suggests that both the incidence and prevalence of TB in SLE patients are high. This study provides a more specific understanding of SLE-TB, which can help health policymakers in the development of preventive strategies for reducing the SLE-TB burden.

show abstract

Prevalence and risk factors of active tuberculosis in patients with rheumatic diseases: a multi-center, cross-sectional study in China

Cited by 13 publications

References 31 publications

Global tuberculosis disease and infection in systemic lupus erythematosus patients: A systematic review and meta-analysis

Global tuberculosis disease and infection in systemic lupus erythematosus patients: A systematic review and meta-analysis

Clinical characteristics and related influencing factors of common rheumatic diseases concomitant with tuberculosis

Incidence and prevalence of tuberculosis in systemic lupus erythematosus patients: A systematic review and meta-analysis

Contact Info

Product

Resources

About