Adherence to tuberculosis infection treatment and its impact on prevention of tuberculosis reactivation: A retrospective cohort study from Taiwan.

IF 4 3区医学 Q1 INFECTIOUS DISEASES

Journal of Infection and Public Health Pub Date : 2025-07-31 DOI:10.1016/j.jiph.2025.102917

Ying-Chun Chien, Chin-Hao Chang, Chin-Chung Shu, Hao-Chien Wang, Chong-Jen Yu

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引用次数: 0

Abstract

Background: Treatment for tuberculosis infection (TBI) is often discontinued owing to adverse drug effects. The impact of treatment completion on TB reactivation remains poorly understood.

Methods: We conducted a retrospective analysis of 1432 patients at one medical centre in Taiwan from 2016 to 2021. Patients with TBI were divided into three groups: non-initiation (N), incomplete treatment (IC), and complete treatment (C). Those exposure to TB but without TBI formed a control group. TB reactivation was analysed using multivariable Cox regression models, with follow-up for up to three years.

Results: The overall TB reactivation rate was 2.3 % (34/1432), ranging from 6.1 % in the TBI (N) group (n = 378), 2.1 % in the TBI (IC) group (n = 330), 0.5 % in the TBI (C) group (n = 430), and 0.7 % in the control group (n = 294). TBI treatment was independently associated with a reduced risk of TB reactivation. The adjusted hazard ratio (aHR) for TBI (IC) versus TBI (N) was 0.32 (95 % CI 0.12-0.85, p = 0.022), and for TBI (C) versus TBI (N), the aHR was 0.05 (95 % CI 0.01-0.29, p < 0.001). Each 10 % increase in treatment adherence rate resulted in a 23 % reduction in the risk of TB reactivation (aHR 0.77, 95 % CI 0.67-0.88, p < 0.001).

Conclusions: TBI treatment, prescribed to 67 % and completed by 38 % of patients, significantly reduces TB reactivation risk, especially with high adherence. Enhancing adherence, particularly among elderly patients and those with comorbidities, is crucial for improving the effectiveness of TBI treatment.

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结核感染治疗依从性及其对预防结核再激活的影响：台湾回顾性队列研究。

背景：结核感染（TBI）的治疗经常因药物不良反应而中断。完成治疗对结核病再激活的影响仍然知之甚少。方法：对2016年至2021年台湾某医疗中心1432例患者进行回顾性分析。TBI患者分为三组：未开始治疗(N)、不完全治疗（IC）和完全治疗(C)。那些接触过结核病但没有创伤性脑损伤的人组成了对照组。使用多变量Cox回归模型分析结核病再激活情况，随访时间长达三年。结果:整体结核病重新激活率是2.3 %(34/1432),从6.1 %在创伤性脑损伤(N)组(N = 378),2.1 %在创伤性脑损伤(IC)组(N = 330),0.5 %在创伤性脑损伤(C)组(N = 430)和0.7 %在对照组(N = 294)。TBI治疗与结核病再激活风险降低独立相关。TBI （IC）与TBI (N)的校正危险比（aHR）为0.32(95 % CI 0.12-0.85, p = 0.022),TBI (C)与TBI (N)的校正危险比（aHR）为0.05（95 % CI 0.01-0.29, p ）结论：TBI治疗，处方率为67% %，完成率为38% %的患者，显著降低了结核病再激活风险，特别是高依从性。加强依从性，特别是老年患者和有合并症的患者，对于提高创伤性脑损伤治疗的有效性至关重要。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Infection and Public Health PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH -INFECTIOUS DISEASES

CiteScore

13.10

自引率

1.50%

发文量

203

审稿时长

96 days

期刊介绍： The Journal of Infection and Public Health, first official journal of the Saudi Arabian Ministry of National Guard Health Affairs, King Saud Bin Abdulaziz University for Health Sciences and the Saudi Association for Public Health, aims to be the foremost scientific, peer-reviewed journal encompassing infection prevention and control, microbiology, infectious diseases, public health and the application of healthcare epidemiology to the evaluation of health outcomes. The point of view of the journal is that infection and public health are closely intertwined and that advances in one area will have positive consequences on the other. The journal will be useful to all health professionals who are partners in the management of patients with communicable diseases, keeping them up to date. The journal is proud to have an international and diverse editorial board that will assist and facilitate the publication of articles that reflect a global view on infection control and public health, as well as emphasizing our focus on supporting the needs of public health practitioners. It is our aim to improve healthcare by reducing risk of infection and related adverse outcomes by critical review, selection, and dissemination of new and relevant information in the field of infection control, public health and infectious diseases in all healthcare settings and the community.