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Associations between selected immune-mediated diseases and tuberculosis: record-linkage studies
Sreeram V Ramagopalan1, Raph Goldacre, Andrew Skingsley
1Department of Physiology, Anatomy and Genetics and Medical Research Council Functional Genomics Unit, University of Oxford, Parks Road, Oxford, OX1 3PT, UK.
BMC Medicine
|April 6, 2013
Summary
Patients with certain immune-mediated diseases show a higher risk of developing tuberculosis (TB). This study highlights specific conditions linked to increased TB risk, informing public health strategies.
Area of Science:
- Epidemiology
- Immunology
- Infectious Diseases
Background:
- Previous research suggests a link between immune-mediated diseases and tuberculosis (TB) risk.
- Understanding this association is crucial for public health and patient management.
Purpose of the Study:
- To investigate the association between immune-mediated diseases and the risk of tuberculosis.
- To identify specific immune-mediated diseases that confer an elevated risk of TB.
Main Methods:
- Analysis of linked hospital admission and death certificate data for the entire population of England (1999-2011).
- Utilized the Oxford Record Linkage Study (ORLS) database for an earlier period in southern England.
- Calculated rate ratios for TB in cohorts with immune-mediated diseases compared to control cohorts.
Main Results:
- Significantly elevated TB risks were observed in patients with numerous immune-mediated diseases, including Addison's disease, rheumatoid arthritis, and systemic lupus erythematosus (SLE).
- Notably high rate ratios for TB were found for Addison's disease (RR=11.9), Goodpasture's syndrome (RR=10.8), and SLE (RR=9.4).
- The study identified a broad spectrum of immune-mediated conditions associated with increased TB incidence.
Conclusions:
- The study confirms an increased risk of TB in patients with certain immune-mediated diseases.
- While the direction of risk and potential confounding factors require further investigation, these findings are valuable for TB screening and policy.
- The results support the need for targeted TB screening and control measures in individuals with specific immune-mediated conditions.
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