Emerging Microbes and Infections (Jan 2021)
Prevalence and risk factors of active tuberculosis in patients with rheumatic diseases: a multi-center, cross-sectional study in China
- Xiaoqing Liu,
- Lifan Zhang,
- Fengchun Zhang,
- Xiaofeng Zeng,
- Yan Zhao,
- Qian Wang,
- Shengyun Liu,
- Xiaoxia Zuo,
- Zhiyi Zhang,
- Huaxiang Wu,
- Sheng Chen,
- Hongbin Li,
- Ping Zhu,
- Lijun Wu,
- Wencheng Qi,
- Yi Liu,
- Miaojia Zhang,
- Huaxiang Liu,
- Dong Xu,
- Wenjie Zheng,
- Yueqiu Zhang,
- Xiaochun Shi,
- Lishuai Han,
- Yaou Zhou,
- Yanping Zhao,
- Wenwen Wang,
- Ting Li,
- Ning Tie,
- Kui Zhang,
- Cainan Luo,
- Baoqi Gong,
- Yi Zhao,
- Chengyin Lv,
- Lijun Song,
- Qingjun Wu,
- Yunyun Fei,
- Lei Zhang,
- Hui Luo,
- Jiaying Sun,
- Jing Xue,
- Liyang Gu,
- Jing Wang,
- Qing Han,
- Kuerbanjiang Yimaity,
- Jiaxin Zhou,
- Lidan Zhao,
- Sainan Bian,
- Wufang Qi,
- Yanhong Li,
- Yujing Zhu,
- Huijun Han,
- Susu Liao,
- Gaifen Liu
Affiliations
- Xiaoqing Liu
- Division of Infectious Diseases, Department of Internal Medicine, State Key Laboratory of Complex Severe and Rare Disease, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, People’s Republic of China
- Lifan Zhang
- Division of Infectious Diseases, Department of Internal Medicine, State Key Laboratory of Complex Severe and Rare Disease, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, People’s Republic of China
- Fengchun Zhang
- Department of Rheumatology and Clinical Immunology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Key Laboratory of Rheumatology & Clinical Immunology, Ministry of Education, Beijing, People’s Republic of China
- Xiaofeng Zeng
- Department of Rheumatology and Clinical Immunology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Key Laboratory of Rheumatology & Clinical Immunology, Ministry of Education, Beijing, People’s Republic of China
- Yan Zhao
- Department of Rheumatology and Clinical Immunology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Key Laboratory of Rheumatology & Clinical Immunology, Ministry of Education, Beijing, People’s Republic of China
- Qian Wang
- Department of Rheumatology and Clinical Immunology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Key Laboratory of Rheumatology & Clinical Immunology, Ministry of Education, Beijing, People’s Republic of China
- Shengyun Liu
- Department of Rheumatology and Immunology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, People’s Republic of China
- Xiaoxia Zuo
- Department of Rheumatology and Immunology, Xiangya Hospital, Central South University, Changsha, People’s Republic of China
- Zhiyi Zhang
- Department of Rheumatology and Immunology, The First Affiliated Hospital of Harbin Medical University, Harbin, People’s Republic of China
- Huaxiang Wu
- Department of Rheumatology, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, People’s Republic of China
- Sheng Chen
- Department of Rheumatology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, People’s Republic of China
- Hongbin Li
- Department of Rheumatology and Immunology, The Affiliated Hospital of Inner Mongolia Medical University, Hohhot, People’s Republic of China
- Ping Zhu
- Department of Clinical Immunology, Xijing Hospital, Fourth Military Medical University, Xi'an, People’s Republic of China
- Lijun Wu
- Department of Rheumatology, People's Hospital of Xinjiang Uygur Autonomous Region, Urumchi, People’s Republic of China
- Wencheng Qi
- Department of Rheumatology, Tianjin First Central Hospital, Tianjin, People’s Republic of China
- Yi Liu
- Department of Rheumatology and Immunology, West China Hospital, Sichuan University, Chengdu, People’s Republic of China
- Miaojia Zhang
- Department of Rheumatology, The first affiliated hospital of Nanjing Medical University, Nanjing, People’s Republic of China
- Huaxiang Liu
- Department of Rheumatology, Qilu Hospital of Shandong University, Ji'nan, People’s Republic of China
- Dong Xu
- Department of Rheumatology and Clinical Immunology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Key Laboratory of Rheumatology & Clinical Immunology, Ministry of Education, Beijing, People’s Republic of China
- Wenjie Zheng
- Department of Rheumatology and Clinical Immunology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Key Laboratory of Rheumatology & Clinical Immunology, Ministry of Education, Beijing, People’s Republic of China
- Yueqiu Zhang
- Department of Rheumatology and Clinical Immunology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Key Laboratory of Rheumatology & Clinical Immunology, Ministry of Education, Beijing, People’s Republic of China
- Xiaochun Shi
- Department of Rheumatology and Clinical Immunology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Key Laboratory of Rheumatology & Clinical Immunology, Ministry of Education, Beijing, People’s Republic of China
- Lishuai Han
- Department of Rheumatology and Immunology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, People’s Republic of China
- Yaou Zhou
- Department of Rheumatology and Immunology, Xiangya Hospital, Central South University, Changsha, People’s Republic of China
- Yanping Zhao
- Department of Rheumatology and Immunology, The First Affiliated Hospital of Harbin Medical University, Harbin, People’s Republic of China
- Wenwen Wang
- Department of Rheumatology, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, People’s Republic of China
- Ting Li
- Department of Rheumatology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, People’s Republic of China
- Ning Tie
- Department of Rheumatology and Immunology, The Affiliated Hospital of Inner Mongolia Medical University, Hohhot, People’s Republic of China
- Kui Zhang
- Department of Clinical Immunology, Xijing Hospital, Fourth Military Medical University, Xi'an, People’s Republic of China
- Cainan Luo
- Department of Rheumatology, People's Hospital of Xinjiang Uygur Autonomous Region, Urumchi, People’s Republic of China
- Baoqi Gong
- Department of Rheumatology, Tianjin First Central Hospital, Tianjin, People’s Republic of China
- Yi Zhao
- Department of Rheumatology and Immunology, West China Hospital, Sichuan University, Chengdu, People’s Republic of China
- Chengyin Lv
- Department of Rheumatology, The first affiliated hospital of Nanjing Medical University, Nanjing, People’s Republic of China
- Lijun Song
- Department of Rheumatology, Qilu Hospital of Shandong University, Ji'nan, People’s Republic of China
- Qingjun Wu
- Department of Rheumatology and Clinical Immunology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Key Laboratory of Rheumatology & Clinical Immunology, Ministry of Education, Beijing, People’s Republic of China
- Yunyun Fei
- Department of Rheumatology and Clinical Immunology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Key Laboratory of Rheumatology & Clinical Immunology, Ministry of Education, Beijing, People’s Republic of China
- Lei Zhang
- Department of Rheumatology and Immunology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, People’s Republic of China
- Hui Luo
- Department of Rheumatology and Immunology, Xiangya Hospital, Central South University, Changsha, People’s Republic of China
- Jiaying Sun
- Department of Rheumatology and Immunology, The First Affiliated Hospital of Harbin Medical University, Harbin, People’s Republic of China
- Jing Xue
- Department of Rheumatology, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, People’s Republic of China
- Liyang Gu
- Department of Rheumatology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, People’s Republic of China
- Jing Wang
- Department of Rheumatology and Immunology, The Affiliated Hospital of Inner Mongolia Medical University, Hohhot, People’s Republic of China
- Qing Han
- Department of Clinical Immunology, Xijing Hospital, Fourth Military Medical University, Xi'an, People’s Republic of China
- Kuerbanjiang Yimaity
- Department of Rheumatology, People's Hospital of Xinjiang Uygur Autonomous Region, Urumchi, People’s Republic of China
- Jiaxin Zhou
- Department of Rheumatology and Clinical Immunology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Key Laboratory of Rheumatology & Clinical Immunology, Ministry of Education, Beijing, People’s Republic of China
- Lidan Zhao
- Department of Rheumatology and Clinical Immunology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Key Laboratory of Rheumatology & Clinical Immunology, Ministry of Education, Beijing, People’s Republic of China
- Sainan Bian
- Department of Rheumatology and Clinical Immunology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Key Laboratory of Rheumatology & Clinical Immunology, Ministry of Education, Beijing, People’s Republic of China
- Wufang Qi
- Department of Rheumatology, Tianjin First Central Hospital, Tianjin, People’s Republic of China
- Yanhong Li
- Department of Rheumatology and Immunology, West China Hospital, Sichuan University, Chengdu, People’s Republic of China
- Yujing Zhu
- Department of Rheumatology, The first affiliated hospital of Nanjing Medical University, Nanjing, People’s Republic of China
- Huijun Han
- Department of Epidemiology and Biostatistics, Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences & School of Basic Medicine, Peking Union Medical College, Beijing, People’s Republic of China
- Susu Liao
- Department of Epidemiology and Biostatistics, Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences & School of Basic Medicine, Peking Union Medical College, Beijing, People’s Republic of China
- Gaifen Liu
- China National Clinical Research Center for Neurological Diseases, Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, People’s Republic of China
- DOI
- https://doi.org/10.1080/22221751.2021.2004864
- Journal volume & issue
-
Vol. 10,
no. 1
pp. 2303 – 2312
Abstract
Evidence of active tuberculosis (ATB) in patients with rheumatic diseases are research priorities but limited data from China have been reported. Research targeting patients not taking anti-TNF biologics are especially insufficient. We aimed to investigate the prevalence and risk factors of ATB in this at-risk population. We conducted a tertiary hospital-based, multi-center, cross-sectional study by using stratified multi-stage cluster sampling strategy to screen ATB in patients with rheumatic diseases. We estimated the prevalence of ATB in patients with rheumatic diseases and identified risk factors among those who were not taking anti-TNF biologic. A total of 13,550 eligible patients were enrolled, and the result showed the standardized prevalence of ATB according to the composition ratio of various types of rheumatic disease was 882/100000 (95% confidence interval (CI): 706-1057). Multivariable logistic regression analysis in patients not taking anti-TNF biologics showed that the independent risk factors of ATB were having systemic lupus erythematosus (SLE) (OR=2.722, 95% CI: 1.437-5.159, p=0.002), having Behcet’s disease (BD) (OR= 5.261, 95% CI: 2.071-13.365, p<0.001), taking azathioprine(AZA) within the past two years (OR=2.095, 95% CI: 0.986-4.450, p=0.054), exposing to glucocorticoids ≥30mg/d for more than four weeks within the past two years (OR=2.031, 95% CI: 1.247-3.309, p=0.004) and having evidences of previous TB (OR= 6.185, 95% CI: 3.487-10.969, p<0.001). The prevalence of ATB was higher in patients with rheumatic diseases compared to the general population. Patients with SLE or BD, prolonged exposure to moderate to high dose of glucocorticoids and previous TB were independent risk factors for ATB.
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