治疗结束12个月后与复发性结核病相关的因素。
Factors associated with recurrent tuberculosis more than 12 months after treatment completion.
作者信息
Kim L, Moonan P K, Heilig C M, Yelk Woodruff R S, Kammerer J S, Haddad M B
机构信息
Epidemic Intelligence Service, Atlanta, Georgia, USA; Division of Tuberculosis Elimination, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
Division of Tuberculosis Elimination, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
出版信息
Int J Tuberc Lung Dis. 2016 Jan;20(1):49-56. doi: 10.5588/ijtld.15.0442.
SETTING
Even among persons who have completed a course of treatment for their first tuberculosis (TB) episode, patients with a history of TB are at higher risk for having TB.
OBJECTIVE
To describe factors from the initial TB episode associated with recurrent TB among patients who completed treatment and remained free of TB for at least 12 months.
DESIGN
During 1993-2006, US TB cases stratified by birth origin were examined. Cox proportional hazards regression was used to assess the association of factors during the initial episode with recurrence at least 12 months after treatment completion.
RESULTS
Among 632 US-born patients, TB recurrence was associated with age 25-44 years (adjusted hazard ratio [aHR] 1.77, 99% confidence interval [CI] 1.02-3.09, attributable fraction [AF] 1-34%), substance use (aHR 1.57, 99%CI 1.23-2.02, AF 8-22%), and treatment supervised by health departments (aHR 1.42, 99%CI 1.03-1.97, AF 2-28%). Among 211 foreign-born patients, recurrence was associated with human immunodeficiency virus infection (aHR 2.24, 99%CI 1.27-3.98, AF 2-9%) and smear-positive TB (aHR 1.56, 99%CI 1.06-2.30, AF 3-33%).
CONCLUSION
Factors associated with recurrence differed by origin of birth, and might be useful for anticipating greater risk for recurrent TB among certain patients with a history of TB.
背景
即使在完成首次结核病（TB）治疗疗程的人群中，有TB病史的患者再次患TB的风险也更高。
目的
描述在完成治疗且至少12个月未患TB的患者中，与TB复发相关的首次TB发作的因素。
设计
在1993年至2006年期间，对按出生来源分层的美国TB病例进行了检查。采用Cox比例风险回归分析评估首次发作时的因素与治疗完成后至少12个月复发之间的关联。
结果
在632名美国出生的患者中，TB复发与25至44岁的年龄（调整风险比[aHR]1.77，99%置信区间[CI]1.02 - 3.09，归因分数[AF]1 - 34%）、药物使用（aHR 1.57，99%CI 1.23 - 2.02，AF 8 - 22%）以及由卫生部门监督治疗（aHR 1.42，99%CI 1.03 - 1.97，AF 2 - 28%）有关。在211名外国出生的患者中，复发与人类免疫缺陷病毒感染（aHR 2.24，99%CI 1.27 - 3.98，AF 2 - 9%）和涂片阳性TB（aHR 1.56，99%CI 1.06 - 2.30，AF 3 - 33%）有关。
结论
与复发相关的因素因出生来源而异，可能有助于预测某些有TB病史的患者中TB复发的更高风险。
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