Marie Helleberg, Daniel Cho, Christina Ekenberg, Søren Sørensen, Marianne Rix, Finn Gustafsson, Allan Rasmussen, Michael Perch, Peter H S Andersen, Jens D Lundgren, Aase Bengaard Andersen
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引用次数: 5
摘要
背景:在一个结核病发病率较低的国家，实体器官移植(SOT)受者和开始慢性透析的患者发生活动性结核病的风险尚未得到很好的阐明。方法:2004-2017年期间在哥本哈根大学医院接受实体器官移植或开始慢性透析的患者，年龄>18岁，从移植或开始透析之日起随访。人口统计和结果数据来自全国登记。结果:我们纳入了1989名SOT接受者和1305名开始慢性透析的患者，分别随访了9785和4196人年(PY)。只有少数患者在SOT或开始透析前进行过潜伏性结核病筛查。来自中/高结核病流行地区的患者中，SOT和透析患者的结核病发病率(IRs)/100,000 PY分别为358 (95% CI 115-1,110)和1,266 (95% CI 681-2354)，而丹麦裔患者的IRs为11 (95% CI 2-81)和31 (95% CI 4-218)。结论:来自结核病中/高流行国家的免疫抑制移民的结核病发病率非常高，而来自结核病低流行国家的患者的结核病风险很小。
Tuberculosis among Patients Undergoing Solid Organ Transplantation or Dialysis in a Low-Endemic Country, 2004-2017.
Background: The risk of active TB among solid organ transplant (SOT) recipients and patients initiating chronic dialysis in a country with low incidence of TB is not well elucidated.
Methods: Patients aged >18 years who were transplanted with a solid organ or initiated chronic dialysis at Copenhagen University Hospital in the period 2004-2017 were followed from date of transplantation or initiation of dialysis. Data on demographics and outcomes were obtained from nationwide registries.
Results: We included 1,989 SOT recipients and 1,305 patients initiating chronic dialysis, who were followed for a total of 9,785 and 4,196 person-years (PY), respectively. Only a minority of patients had been screened for latent TB prior to SOT or initiation of dialysis. The incidence rates (IRs)/100,000 PY of TB among patients from medium/high TB endemic areas were 358 (95% CI 115-1,110) and 1,266 (95% CI 681-2354) for SOT and dialysis patients, respectively, whereas IRs among patients of Danish origin were 11 (95% CI 2-81) and 31 (95% CI 4-218).
Conclusion: The incidence of TB among immunosuppressed immigrants from medium/high TB endemic countries was very high, while the risk of TB among patients from low-endemic countries was minimal.
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