Sundaram Karthikeyan, Vajravelu Leela Kagithakara, Velayutham Ravichandiran, Mohan Utpal
Department of Microbiology, SRM Medical College Hospital and Research Centre, Kattangulathur, Chennai, 603203, Tamilnadu, India.
Department of Natural Products, NIPER-Kolkata, Bengal Chemicals, Chunilal Bhawan, Kankurgachi, Kolkata, 700054, West Bengal, India.
Indian J Tuberc. 2025 Apr;72(2):174-182. doi: 10.1016/j.ijtb.2023.07.001. Epub 2023 Jul 6.
Tuberculosis is a contagious disease that ranks among the top ten killers of humans worldwide. Mycobacterium tuberculosis is an etiological agent of tuberculosis. The prognosis of tuberculosis in patients with autoimmune diseases is high due to treatment with anti-TNF-alpha therapy.
We analyzed the studies based on the Preferred Reporting Items and Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Methods of eligibility criteria, search criteria and critical analyses, biased and challenges, and intervention.
We observed the tuberculosis incidence of 595 (3.25%; 95% CI- 2.9 - 3.5) cases in systemic lupus erythematosus, 332 (4.54%; 95% CI - 4.07 - 5.01) in rheumatoid arthritis, and 25 (1.9%; 95% CI - 1.16 - 2.64) in multiple sclerosis out of 26,870 study populations in the various studies, and a total of 93 (7.2%; 95% CI - 5.8 - 8.6) cases in MS, and 10 (0.05%; 95% CI - 0.02 - 0.08) in SLE reported of TB indeterminate results.
This systematic review comprehensively analyzed the recent studies of the disease progression of latent tuberculosis infection to active tuberculosis is high in treatments with glucocorticoid, azathioprine, prednisone, and leflunomide among patients with autoimmune diseases.
We summarized recent studies emphasizing the risk factors of tuberculosis to be found the disease-modifying anti-rheumatic drug (DMARD), immunosuppressive treatments given to biologic-naive patients as the dominant factor associated with the risk of TB and treatment with a tumor necrosis factor inhibitor.
结核病是一种传染性疾病，在全球人类十大死因中名列前茅。结核分枝杆菌是结核病的病原体。由于使用抗TNF-α疗法进行治疗，自身免疫性疾病患者患结核病的预后风险较高。
我们根据优先报告项目及系统评价和荟萃分析（PRISMA）指南对研究进行了分析。包括纳入标准、检索标准和批判性分析方法、偏差和挑战以及干预措施。
在各项研究的26,870个研究人群中，我们观察到系统性红斑狼疮患者的结核病发病率为595例（3.25%；95%置信区间-2.9-3.5），类风湿关节炎患者为332例（4.54%；95%置信区间-4.07-5.01），多发性硬化症患者为25例（1.9%；95%置信区间-1.16-2.64），MS患者中共有93例（7.2%；95%置信区间-5.8-8.6），SLE患者中有10例（0.05%；95%置信区间-0.02-0.08）报告结核病检测结果不确定。
本系统评价全面分析了近期关于自身免疫性疾病患者中，潜伏性结核感染进展为活动性结核在糖皮质激素、硫唑嘌呤、泼尼松和来氟米特治疗中发病率较高的研究。
我们总结了近期研究，强调结核病的危险因素为疾病改善抗风湿药物（DMARD），给予未使用过生物制剂的患者免疫抑制治疗是与结核病风险相关的主要因素以及使用肿瘤坏死因子抑制剂进行治疗。
