Latent tuberculosis infection, tuberculin skin test and vitamin D status in contacts of tuberculosis patients: a cross-sectional and case-control study

BMC Infectious Diseases

Vicenta Rodrigo Bartual³  Noemi Meseguer Ferrer²  Esther Silvestre Silvestre²  Lourdes Safont Adsuara²  José Antonio Ferrero-Vega⁵  Juan Bellido-Blasco¹  María Jesús Sanchis Piñana⁵  Concepción Herrero-Carot²  Jesús Iborra-Millet⁵  Rita Holguín-Gómez⁴  Daniel Garcia-Ferrer⁵  Angeles Romeu-Garcia²  José Vicente Juan-Cerdán⁵  Alberto Arnedo-Pena¹ 

[1] CIBER of Epidemiology and Public Health (CIBERESP), Barcelona, Spain;Epidemiology Division. Public Health Center Castellón, Spain;Preventive Medicine. Hospital Provincial. Castellón, Spain;Preventive Medicine. Hospital La Plana. Vila-real, Spain;Laboratory of Biochemical. Hospital General. Castellón, Spain

关键词: Case-control study;    Tuberculin skin test conversion;    Latent tuberculosis infection;    Vitamin D;    Tuberculosis;   

Others  :  1175500
DOI  :  10.1186/1471-2334-11-349

 received in 2011-07-04, accepted in 2011-12-15,  发布年份 2011

【 摘 要 】

Background

Deficient serum vitamin D levels have been associated with incidence of tuberculosis (TB), and latent tuberculosis infection (LTBI). However, to our knowledge, no studies on vitamin D status and tuberculin skin test (TST) conversion have been published to date. The aim of this study was to estimate the associations of serum 25-hydroxyvitamin D₃ (25[OH]D) status with LTBI prevalence and TST conversion in contacts of active TB in Castellon (Spain).

Methods

The study was designed in two phases: cross-sectional and case-control. From November 2009 to October 2010, contacts of 42 TB patients (36 pulmonary, and 6 extra-pulmonary) were studied in order to screen for TB. LTBI and TST conversion cases were defined following TST, clinical, analytic and radiographic examinations. Serum 25(OH)D levels were measured by electrochemiluminescence immunoassay (ECLIA) on a COBAS^® 410 ROCHE^® analyzer. Logistic regression models were used in the statistical analysis.

Results

The study comprised 202 people with a participation rate of 60.1%. Only 20.3% of the participants had a sufficient serum 25(OH)D (≥ 30 ng/ml) level. In the cross-sectional phase, 50 participants had LTBI and no association between LTBI status and serum 25(OH)D was found. After 2 months, 11 out of 93 negative LTBI participants, without primary prophylaxis, presented TST conversion with initial serum 25(OH)D levels: a:19.4% (7/36): < 20 ng/ml, b:12.5% (4/32):20-29 ng/ml, and c:0%(0/25) ≥ 30 ng/ml. A sufficient serum 25(OH)D level was a protector against TST conversion a: Odds Ratio (OR) = 1.00; b: OR = 0.49 (95% confidence interval (CI) 0.07-2.66); and c: OR = 0.10 (95% CI 0.00-0.76), trends p = 0.019, adjusted for high exposure and sputum acid-fast bacilli positive index cases. The mean of serum level 25(OH)D in TST conversion cases was lower than controls,17.5 ± 5.6 ng/ml versus 25.9 ± 13.7 ng/ml (p = 0.041).

Conclusions

The results suggest that sufficient serum 25(OH)D levels protect against TST conversion.

【 授权许可】

   
2011 Arnedo-Pena et al; licensee BioMed Central Ltd.

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