Preprint Article Version 1 Preserved in Portico This version is not peer-reviewed

Antineutrophil Cytoplasmic Antibody-associated Vasculitis and the Risk of Developing Incidental Tuberculosis: A Population-based Cohort Study

Shan-Ho Chan
ORCID logo ,
Ming-Feng Li
ORCID logo ,
Shih-Hsiang Ou
,
Mei-Chen Lin
,
Jen-Hung Wang
ORCID logo ,
Po-Tsang Lee
,
Hsin-Yu Chen
* ORCID logo
Version 1 : Received: 12 October 2023 / Approved: 13 October 2023 / Online: 13 October 2023 (08:10:55 CEST)

A peer-reviewed article of this Preprint also exists.

Chan, S.-H.; Li, M.-F.; Ou, S.-H.; Lin, M.-C.; Wang, J.-H.; Lee, P.-T.; Chen, H.-Y. Antineutrophil Cytoplasmic Antibody-Associated Vasculitis and the Risk of Developing Incidental Tuberculosis: A Population-Based Cohort Study. Medicina 2023, 59, 1920. Chan, S.-H.; Li, M.-F.; Ou, S.-H.; Lin, M.-C.; Wang, J.-H.; Lee, P.-T.; Chen, H.-Y. Antineutrophil Cytoplasmic Antibody-Associated Vasculitis and the Risk of Developing Incidental Tuberculosis: A Population-Based Cohort Study. Medicina 2023, 59, 1920.

Abstract

Background and Objectives: Treatment for antineutrophil cytoplasmic antibody-associated vasculitis (AAV) must deal with immunosuppression as well as infections associated with compromised immune system, such as tuberculosis (TB). Our aim was to overcome the gap in the literature concerning the risk of incidental TB after diagnosis of AAV. Materials and Methods: This retrospective population-based cohort study was based on the data from the National Health Insurance Research Database in Taiwan. We used a novel algorithm to identify patients with newly diagnosed granulomatous polyangiitis (GPA) or microscopic polyangiitis (MPA) between January 1, 2000 and December 31, 2012. The primary outcome was risk of incidental TB. Cox proportional hazard models were used to evaluate the association between AAV and incidental TB. Results: A total of 2,257 patients with AAV and a propensity-score matched cohort of 9,028 patients were studied. Overall, patients with AAV were at a 1.48x higher risk of contracting incidental TB than were patients in the matched cohort (adjusted HR 1.48; 95% confidence interval [CI], 1.02-2.15). Note that the highest risk of contracting incidental TB was in the first two years following a diagnosis of AAV, with a nearly 1-fold increase in risk (adjusted HR, 1.91; 95% CI, 1.01-3.60). Female AAV patients were 3.24x more likely than females without AAV to develop TB (adjusted HR 3.24; 95%CI, 1.85-5.67). Conclusion: Patients with AAV face an elevated risk of contracting incidental TB, particularly within the first two years after AAV diagnosis. The risk of contracting TB is higher among female AAV patients than among females without AAV.

Keywords

antineutrophil cytoplasmic antibody-associated vasculitis; tuberculosis; population-based study

Subject

Medicine and Pharmacology, Internal Medicine

Copyright: This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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