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

Research Article

Lourdes Safont Adsuara¹  Noemi Meseguer Ferrer¹  Angeles Romeu-Garcia¹  Concepción Herrero-Carot¹  Esther Silvestre Silvestre¹  Alberto Arnedo-Pena²  Juan Bellido-Blasco²  José Vicente Juan-Cerdán³  Daniel Garcia-Ferrer³  María Jesús Sanchis Piñana³  José Antonio Ferrero-Vega³  Jesús Iborra-Millet³  Rita Holguín-Gómez⁴  Vicenta Rodrigo Bartual⁵ 

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

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

DOI  :  10.1186/1471-2334-11-349

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

来源: Springer

【 摘 要 】

BackgroundDeficient 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).MethodsThe 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.ResultsThe 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).ConclusionsThe results suggest that sufficient serum 25(OH)D levels protect against TST conversion.

【 授权许可】

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