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墨西哥类风湿关节炎(RA)患者中潜伏性结核感染(LTBI)的患病率

Prevalence of Latent Tuberculosis Infection (LTBI) in Mexican Patients With Rheumatoid Arthritis (RA).

作者信息

Zavala Del Ángel Abel Eduardo, Morales-Romero Jaime, Zenteno-Cuevas Roberto, Enciso Moreno José Antonio, Mata Miranda María Del Pilar, Martínez Zapata Jorge Luis, Sampieri Ramírez Clara Luz, Nachón García María Gabriela, Blázquez Morales María Sobeida Leticia, Álvarez-Bañuelos María Teresa, Cruz López José Artemio, Demeneghi-Marini Verónica Patricia, González-López Laura, Gámez-Nava Jorge Iván

机构信息

Health Sciences Institute, Universidad Veracruzana, Xalapa, MEX.

Public Health Institute, Universidad Veracruzana, Xalapa, MEX.

出版信息

Cureus. 2023 May 30;15(5):e39743. doi: 10.7759/cureus.39743. eCollection 2023 May.

Abstract

INTRODUCTION

Patients with rheumatoid arthritis (RA) are at increased risk of developing tuberculosis, and even more so if they receive biological agents. In Mexico, the prevalence of latent tuberculosis infection (LTBI) in RA diagnosed by interferon-gamma release assay (IGRA) is largely unknown. The objective was to determine LTBI prevalence and the associated risk factors in rheumatoid arthritis patients.

METHODS

A cross-sectional study was performed comprising 82 patients with RA who attended the rheumatology service at a second-level hospital. Demographic characteristics, comorbidity, Bacillus Calmette-Guerin (BCG) vaccination and smoking history, type of treatment, disease activity and functional capacity were investigated. The Disease Activity Score 28 and the Health Assessment Questionnaire-Disability Index were applied for the estimate of RA activity and functional capacity. Further information was compiled from the electronic medical records and personal interviews. LTBI was determined by QuantiFERON TB Gold Plus (QIAGEN, Germantown, USA).

RESULTS

Prevalence of LTBI was 14% (95% confidence interval (CI): 8.6% to 23.9%). Factors associated with LTBI were history of smoking (odds ratio (OR) = 6.63 95% CI 1.01 to 43.3) and disability score (OR = 7.19 95%CI 1.41 to 36.6).

CONCLUSIONS

The prevalence of LTBI in Mexican patients with RA was 14%. Our results suggest prevention of smoking and functional incapacity could reduce the risk of LTBI. Further research could endorse our results.

摘要

引言

类风湿关节炎(RA)患者患结核病的风险增加,如果他们接受生物制剂治疗,风险更高。在墨西哥,通过干扰素-γ释放试验(IGRA)诊断的RA患者中潜伏性结核感染(LTBI)的患病率很大程度上未知。目的是确定类风湿关节炎患者中LTBI的患病率及其相关危险因素。

方法

进行了一项横断面研究,纳入了82名在二级医院风湿科就诊的RA患者。调查了人口统计学特征、合并症、卡介苗(BCG)接种和吸烟史、治疗类型、疾病活动度和功能能力。应用疾病活动评分28和健康评估问卷残疾指数来评估RA活动度和功能能力。从电子病历和个人访谈中收集更多信息。LTBI通过QuantiFERON TB Gold Plus(QIAGEN,美国日耳曼敦)测定。

结果

LTBI的患病率为14%(95%置信区间(CI):8.6%至23.9%)。与LTBI相关的因素是吸烟史(比值比(OR)=6.63,95%CI 1.01至43.3)和残疾评分(OR=7.19,95%CI 1.41至36.6)。

结论

墨西哥RA患者中LTBI的患病率为14%。我们的结果表明,预防吸烟和功能丧失可降低LTBI的风险。进一步的研究可以证实我们的结果。

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