欧洲固体器官移植接受者的结核病发病率:多中心TBnet队列研究
Berit Lange1, Thomas Theo Brehm2, Sandra M Arend3
1Department of Epidemiology, Helmholtz Centre for Infection Research (HZI), Braunschweig, Germany; German Center for Infection Research (DZIF), Braunschweig, Germany.
The Journal of infection
|December 22, 2025
概括
固体器官移植接受者患结核病的风险更高. 针对性查和结核病预防疗法至关重要,特别是在南欧,以减少移植后感染率.
科学领域:
- 移植免疫学 移植免疫学
- 传染病流行病学 传染病流行病学
- 公共卫生 公共卫生
背景情况:
- 固体器官移植 (SOT) 接受者患结核病 (TB) 的风险增加.
- 在低到中等发病率地区,SOT接收者的最佳结核病预防策略尚未确定.
- 欧洲SOT接收者代表一个需要具体结核病风险评估的弱势群体.
研究的目的:
- 确定欧洲SOT接受者移植后结核病的发病率和风险因素.
- 评估结核查和预防治疗 (TPT) 在这一群体中的有效性.
- 为SOT接收者制定区域适应的结核病预防策略提供信息.
主要方法:
- 一个多中心的回顾性队列研究,涉及5805名成年SOT接受者,在2007-2012年间在15个欧洲中心移植.
- 通过微生物学证实移植后结核病作为主要结局的2018年的后续.
- 使用世卫组织数据计算每10万人/年的发病率和标准化发病率 (SIRs);用于风险因素分析的Cox模型.
主要成果:
- 在33785人/年 (发病率:68.0/100,000人/年) 期间,共发生了23例肺结核病例 (0.4%).
- 结核病发病率最高的患者是检测阳性但没有TPT (233.8/100,000).
- 与中欧相比,南欧的发病率和SIR显著更高,南欧接收者 (SIR 12.8) 和有移民史的人 (HR 2.7) 风险较高.
结论:
- 在欧洲接受SOT的患者中,结核病的风险显著增加.
- 区域性定制的预防策略至关重要,包括在发病率较低的地区进行有针对性的查和在发病率较高的地区进行普遍查.
- 改善查和结核病预防疗法 (TPT) 是有必要的,以减轻SOT接受者的结核病风险.
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