Factors associated with recurrent tuberculosis more than 12 months after treatment completion

SETTING: Even among persons who have completed a course of treatment for their first tuberculosis (TB) episode, patients with a history of TB are at higher risk for having TB.OBJECTIVE: To describe factors from the initial TB episode associated with recurrent TB among patients who completed treatmen...

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Bibliographic Details
Published in:The international journal of tuberculosis and lung disease 2016-01, Vol.20 (1), p.49-56
Main Authors: Kim, L., Moonan, P. K., Heilig, C. M., Woodruff, R. S. Yelk, Kammerer, J. S., Haddad, M. B.
Format: Article
Language:English
Subjects:
Adolescent
Adult
Aged
Antitubercular Agents - therapeutic use
Child
Child, Preschool
Cohort Studies
Female
Human immunodeficiency virus
Humans
Infant
Infant, Newborn
Male
Middle Aged
Mycobacterium
Mycobacterium Tuberculosis
Proportional Hazards Models
Reactivation
Recurrence
Reinfection
Retrospective Studies
Risk Factors
Treatment Outcome
Tuberculosis, Pulmonary - drug therapy
Tuberculosis, Pulmonary - epidemiology
Tuberculosis, Pulmonary - etiology
United States
United States - epidemiology
Young Adult
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Summary:SETTING: Even among persons who have completed a course of treatment for their first tuberculosis (TB) episode, patients with a history of TB are at higher risk for having TB.OBJECTIVE: To describe factors from the initial TB episode associated with recurrent TB among patients who completed treatment and remained free of TB for at least 12 months.DESIGN: During 1993-2006, US TB cases stratified by birth origin were examined. Cox proportional hazards regression was used to assess the association of factors during the initial episode with recurrence at least 12 months after treatment completion.RESULTS: Among 632 US-born patients, TB recurrence was associated with age 25-44 years (adjusted hazard ratio [aHR] 1.77, 99% confidence interval [CI] 1.02-3.09, attributable fraction [AF] 1-34%), substance use (aHR 1.57, 99%CI 1.23-2.02, AF 8-22%), and treatment supervised by health departments (aHR 1.42, 99%CI 1.03-1.97, AF 2-28%). Among 211 foreign-born patients, recurrence was associated with human immunodeficiency virus infection (aHR 2.24, 99%CI 1.27-3.98, AF 2-9%) and smear-positive TB (aHR 1.56, 99%CI 1.06-2.30, AF 3-33%).CONCLUSION: Factors associated with recurrence differed by origin of birth, and might be useful for anticipating greater risk for recurrent TB among certain patients with a history of TB.
ISSN:1027-3719
1815-7920
DOI:10.5588/ijtld.15.0442