印度本地治里和泰米尔纳德邦诊断时的酒精使用与结核病临床表现。

Alcohol use and tuberculosis clinical presentation at the time of diagnosis in Puducherry and Tamil Nadu, India.

机构信息

Section of Infectious Diseases, Boston University School of Medicine and Boston Medical Center, Boston, Massachusetts, United States of America.

Department of Preventive and Social Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research, Gorimedu, Puducherry, India.

出版信息

PLoS One. 2020 Dec 17;15(12):e0240595. doi: 10.1371/journal.pone.0240595. eCollection 2020.

DOI:10.1371/journal.pone.0240595

PMID:33332367

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7746146/

Abstract

SETTING

Alcohol use increases the risk of tuberculosis (TB) disease and is associated with worse outcomes.

OBJECTIVE

To determine whether alcohol use affects TB severity at diagnosis in a high-burden setting.

DESIGN

Participants were smear-positive people living with TB (PLWTB) in India. Disease severity was assessed as 1) high versus low smear grade, 2) time to positivity (TTP) on liquid culture, 3) chest radiograph cavitation, and 4) percent lung affected. Alcohol use and being at-risk for alcohol use disorders (AUD) were assessed using the AUDIT-C. Univariable and multivariable analyses were conducted.

RESULTS

Of 1166 PLWTB, 691 (59.3%) were drinkers; of those, 518/691 (75.0%) were at-risk for AUD. Drinkers had more lung affected than non-drinkers (adjusted mean difference 10.8%, p<0.0001); this was not significant for those at-risk for AUD (adjusted mean difference 3.7%, p = 0.11). High smear grade (aOR 1.0, 95%CI: 0.7-1.4), cavitation (aOR 0.8, 95%CI 0.4-1.8), and TTP (mean difference 5.2 hours, p = 0.51) did not differ between drinkers and non-drinkers, nor between those at-risk and not at-risk for AUD.

CONCLUSIONS

A large proportion of PLWTB were drinkers and were at-risk for AUD. Alcohol drinkers had more lung affected than non-drinkers. Studies are needed to explore mechanisms of this association.

摘要

背景

饮酒会增加患结核病（TB）的风险，并与更差的预后相关。

目的

在高负担环境中，确定饮酒是否会影响 TB 诊断时的严重程度。

设计

参与者为印度的涂片阳性肺结核患者（PLWTB）。疾病严重程度评估为 1）高 versus 低涂片等级，2）液体培养的阳性时间（TTP），3）胸部 X 光片空洞形成，和 4）受影响的肺百分比。使用 AUDIT-C 评估饮酒和酒精使用障碍（AUD）风险。进行单变量和多变量分析。

结果

在 1166 名 PLWTB 中，有 691 名（59.3%）为饮酒者；其中 518/691（75.0%）有 AUD 风险。饮酒者比非饮酒者受影响的肺更多（调整后的平均差异为 10.8%，p<0.0001）；而对于有 AUD 风险的人，这一差异并不显著（调整后的平均差异为 3.7%，p = 0.11）。高涂片等级（优势比 1.0，95%CI：0.7-1.4）、空洞形成（优势比 0.8，95%CI 0.4-1.8）和 TTP（平均差异 5.2 小时，p = 0.51）在饮酒者和非饮酒者之间以及有 AUD 风险和无 AUD 风险者之间没有差异。