老年潜伏性结核感染治疗的安全性和完成情况：台湾的一项前瞻性观察研究。
Safety and treatment completion of latent tuberculosis infection treatment in the elderly population-A prospective observational study in Taiwan.
机构信息
Department of Chest Medicine, Taipei Veterans General Hospital, Taipei, Taiwan; School of Medicine, National Yang-Ming University, Taipei, Taiwan.
Department of Life Sciences, National Chung Hsing University, Taichung, Taiwan; Division of Chest Medicine, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung, Taiwan; Department of Medical Technology, Jen-Teh Junior College of Medicine, Nursing and Management, Miaoli, Taiwan; Department of Industrial Engineering and Enterprise Information, Tunghai University, Taichung, Taiwan.
出版信息
Int J Infect Dis. 2020 Jul;96:550-557. doi: 10.1016/j.ijid.2020.05.009. Epub 2020 May 17.
BACKGROUND
The detection and treatment of latent tuberculosis infection (LTBI) is a key step in eliminating tuberculosis (TB), but information on safety and on treatment interruption in elderly LTBI patients remains limited.
METHODS
This multicenter prospective observational study included individuals with LTBI who underwent preventive therapy. Incidents of systemic adverse reactions (SARs) and treatment interruption rates in an elderly group (≥60 years old) and a young group (<60 years old) were analyzed.
RESULTS
A total of 406 LTBI patients, comprising 167 elderly and 239 young patients, were included in the analyses. The incidence of SARs was similar in the elderly group (18%) and the young group (15.1%). Being middle-aged (35-59 years), body mass index <23 kg/m, a regimen of 3 months of once-weekly rifapentine plus isoniazid, and end-stage renal disease were independent factors associated with SARs. The treatment interruption rate was similar between the elderly group (21.6%) and the young group (15.9%). LTBI patients aged ≥80 years with SARs had the highest risk of treatment interruption.
CONCLUSIONS
The occurrence of SARs was similar in the elderly (≥60 years old) and young (<60 years old) LTBI patients receiving preventive therapy. Extremely old (≥80 years old) LTBI patients had a higher treatment interruption rate, especially when they had SARs.
背景
潜伏性结核感染（LTBI）的检测和治疗是消除结核病（TB）的关键步骤，但关于老年 LTBI 患者安全性和治疗中断的信息仍然有限。
方法
这项多中心前瞻性观察性研究纳入了接受预防性治疗的 LTBI 患者。分析了老年组（≥60 岁）和年轻组（<60 岁）中全身不良反应（SARs）的发生率和治疗中断率。
结果
共纳入 406 例 LTBI 患者，其中老年组 167 例，年轻组 239 例。老年组（18%）和年轻组（15.1%）SARs 的发生率相似。中年（35-59 岁）、BMI<23kg/m、3 个月利福平吡嗪酰胺方案每周一次和终末期肾病是 SARs 的独立相关因素。老年组（21.6%）和年轻组（15.9%）的治疗中断率相似。有 SARs 的≥80 岁 LTBI 患者中断治疗的风险最高。
结论
接受预防性治疗的老年（≥60 岁）和年轻（<60 岁）LTBI 患者 SARs 的发生率相似。非常高龄（≥80 岁）的 LTBI 患者治疗中断率更高，尤其是有 SARs 时。
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