Smoking and 2-month culture conversion during anti-tuberculosis treatment

Maciel, Ethel Leonor Nóia; Brioschi, Ana Paula; Peres, Renata Lyrio; Guidoni, Laura; Ribeiro, Fabíola Karla; Hadad, David Jamil; Vinhas, Solange Alves; Zandonade, Eliana; Palaci, Moisés; Dietze, Reynaldo; Johnson, John L.

doi:10.5588/ijtld.12.0426

Cited by 60 publications

(57 citation statements)

References 11 publications

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“…Our observations of more extensive lung disease, lung cavitation and positive sputum smears among current smokers and ex-smokers corroborate those reported in previous studies [16][17][18] and point to potentially enhanced secondary transmission risk [19]. In this study, both current smokers and ex-smokers were 1.5-2 times as likely to remain smear-positive and culture-positive after 2 months of treatment, closely parallel to the observation in a previous Brazilian case-control study that ever-smokers who smoked >20 cigarettes per day were also reported to be two-fold as likely to remain culture-positive after 2 months of treatment [20]. The slower bacteriological response raises concern over persistent transmission risk after the initiation of treatment, even for patients with initially fully drug-sensitive TB as included in the current study.…”

Section: Discussionsupporting

confidence: 74%

Smoking adversely affects treatment response, outcome and relapse in tuberculosis

Leung¹,

Yew

Chan³

et al. 2014

Eur Respir J

141

144

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The impact of smoking on tuberculosis outcome was evaluated in a territory-wide treatment programme.16 345 consecutive patients undergoing chemotherapy for active tuberculosis in government chest clinics in Hong Kong from 2001 to 2003 were followed up prospectively for 2 years for treatment outcome and subsequently tracked through the territory-wide tuberculosis notification registry for relapse until the end of 2012.Smoking was associated with more extensive lung disease, lung cavitation and positive sputum smear and culture at the baseline. In both current smokers and ex-smokers, sputum smears and cultures were significantly more likely to remain positive after 2 months of treatment. Both categories of smokers were significantly less likely to achieve cure or treatment completion within 2 years. Overall, 16.7% of unsuccessful treatment outcomes were attributable to smoking, with the key contributor being default in current smokers and death in ex-smokers. Among successful treatment completers, there was a clear gradient (hazard ratios of 1.00, 1.33 and 1.63) of relapse risk from never-smokers to ex-smokers and current smokers, with an overall population attributable risk of 19.4% (current smokers: 12.2%; ex-smokers: 7.2%).Smoking adversely affects baseline disease severity, bacteriological response, treatment outcome and relapse in tuberculosis. Smoking cessation likely reduces relapse and secondary transmission. @ERSpublications Smoking adversely affects treatment response in TB. Smoking cessation reduces relapse and secondary transmission.

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Section: Discussionsupporting

confidence: 74%

Smoking adversely affects treatment response, outcome and relapse in tuberculosis

Leung¹,

Yew

Chan³

et al. 2014

Eur Respir J

141

144

View full text Add to dashboard Cite

show abstract

“…Mounting evidence from a number of countries in both the developed and developing worlds attests not only to the predisposing effect of smoking for the development of pulmonary TB [105][106][107][108][109][110][111][112], but also for more severe disease progression [113], decreased efficacy of antimicrobial chemotherapy [114], prolonged infectivity [115][116][117], recurrence of disease [118], poor outcomes of multidrug-resistant TB [119] and possibly impaired post-treatment lung function [120].…”

Section: Tuberculosismentioning

confidence: 99%

Impact of HIV infection and smoking on lung immunity and related disorders

2015

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HIV-infected persons not only have higher rates of smoking than the general population, but are also unusually vulnerable to the associated adverse health effects, both infective and noninfective in origin. Indeed, in the setting of well-organised care and availability of highly active antiretroviral therapy, HIV-infected smokers lose more life-years to smoking than to HIV infection per se, presenting a major challenge to healthcare providers. Not surprisingly, the respiratory system is particularly susceptible to the damaging interactive chronic inflammatory and immunosuppressive effects of HIV and smoking, intensifying the risk of the development of opportunistic infections, as well as lung cancer and obstructive lung disorders. The impact of smoking on the immunopathogenesis and frequencies of these respiratory conditions in the setting of HIV infection, as well as on the efficacy of antiretroviral therapy, represent the primary focus of this review. @ERSpublications Smoking exacerbates the immunosuppressive/pro-inflammatory effects of HIV, increasing the risk of pulmonary disease

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“…In the case of the former, however, differences in cavitation, which is largely immune-mediated, may be difficult to detect due to smoking-related pulmonary immune dysfunction; irrespective of this caveat, a previous study involving 13,088 cases of pulmonary TB has, however, documented more severe cavitary disease in smokers 6 . With respect to culture conversion, delayed sputum conversion in smokers has also been reported in several studies [27][28][29] . Follow-up studies may also identify the relative contributions of infection and smoking to the observed alterations in vitamin C status.…”

Section: Discussionmentioning

confidence: 61%

Effect of smoking on acute phase reactants, stress hormone responses and vitamin C in pulmonary tuberculosis

et al. 2017

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Background: Chronic inflammation, possibly exacerbated by cigarette smoking, is considered to be the primary cause of pulmonary damage in patients with tuberculosis (TB). However, the mechanisms which underpin these harmful inflammatory responses, have not been well documented. Objectives: The current study was undertaken to determine possible associations between systemic biomarkers of inflammation (acute phase reactants, stress hormones, leukocyte vitamin C) and smoking status in patients (n=71, 20 smokers) with newly-diagnosed pulmonary TB presenting at a tertiary hospital, Johannesburg, South Africa. Methods: Plasma concentrations of C-reactive protein (CRP), ferritin, cortisol, epinephrine, norepinephrine, dopamine and leukocyte vitamin C were measured using a combination of immunonephelometric, radioimmunoassay, immunochromatographic and spectrophotometric procedures. Demographic, clinical and laboratory data was captured and analysed by parametric and non-parametric analyses where appropriate. Results: Smokers were predominantly males (P<0.0001), of older age (P<0.0003) with a significantly lower body mass index (P<0.03). Plasma levels of CRP, ferritin and dopamine were higher in the group of smokers in the setting of lower levels of epinephrine, and leukocyte vitamin C, with CRP and vitamin C attaining statistical significance (P<0.04 and P<0.02 respectively). Those of cortisol and norepinephrine were comparable to those of non-smokers, as were radiographic changes and clinical indices of disease activity. Conclusion: Cigarette smoking is associated with an exaggerated systemic inflammatory response in pulmonary TB in the setting of decreased concentrations of leukocyte vitamin C. Although no significant associations with radiographic changes and most clinical indices of disease activity were evident on presentation, these pro-inflammatory interactions may have prognostic significance.

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Smoking and 2-month culture conversion during anti-tuberculosis treatment

Cited by 60 publications

References 11 publications

Smoking adversely affects treatment response, outcome and relapse in tuberculosis

Smoking adversely affects treatment response, outcome and relapse in tuberculosis

Impact of HIV infection and smoking on lung immunity and related disorders

Effect of smoking on acute phase reactants, stress hormone responses and vitamin C in pulmonary tuberculosis

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