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BMC Pulm Med. 2019 Feb 13;19(1):40. doi: 10.1186/s12890-019-0804-z.

Asthma and atopy prevalence are not reduced among former tuberculosis patients compared with controls in Lima, Peru.

Byrne AL1,2,3,4, Marais BJ5,6,7, Mitnick CD8,9, Garden FL10,11,12, Lecca L8,9, Contreras C8, Yauri Y13, Garcia F8, Marks GB5,6,10,11,12.

Author information

1
The University of Sydney, St. Vincent's Hospital Sydney, Heart Lung Clinic, Xavier Building. 390, Victoria Street, 2010, Australia. abyrne@med.usyd.edu.au.
2
Socios En Salud Sucursal PerĂº, Partners In Health, Lima, Peru. abyrne@med.usyd.edu.au.
3
Centre for Research Excellence in Tuberculosis (TB-CRE), Sydney, Australia. abyrne@med.usyd.edu.au.
4
Blacktown Hospital Clinical School, University of Western Sydney, Sydney, Australia. abyrne@med.usyd.edu.au.
5
The University of Sydney, St. Vincent's Hospital Sydney, Heart Lung Clinic, Xavier Building. 390, Victoria Street, 2010, Australia.
6
Centre for Research Excellence in Tuberculosis (TB-CRE), Sydney, Australia.
7
Marie Bashir Institute for Infectious Diseases and Biosecurity (MBI), University of Sydney, Sydney, Australia.
8
Socios En Salud Sucursal PerĂº, Partners In Health, Lima, Peru.
9
Harvard Medical School, Boston, MA, USA.
10
The Woolcock Institute of Medical Research, Sydney, Australia.
11
South Western Sydney Clinical School, University of New South Wales, Sydney, Australia.
12
Ingham Institute of Applied Medical Research, Sydney, Australia.
13
Ministry of Health, Red de Salud Lima Ciudad, Lima, Peru.

Abstract

BACKGROUND:

Although there are theoretical reasons for believing that asthma and atopy may be negatively correlated with tuberculosis, epidemiological studies have had conflicting findings.

OBJECTIVE:

To determine if people with confirmed tuberculosis were less likely to be atopic and less likely to have atopic disease including asthma compared to those with no previous tuberculosis.

METHODS:

Patients in Lima, Peru with a prior history of tuberculosis were identified from clinic records in this cohort study. A representative sample of individuals without a prior tuberculosis diagnosis was recruited from the same community. Allergen skin prick testing was performed to classify atopic status. Allergic rhinitis was identified by history. Asthma was defined by symptoms and spirometry. Eosinophilic airway inflammation was measured using exhaled nitric oxide levels.

RESULTS:

We evaluated 177 patients with, and 161 individuals without, previous tuberculosis. There was a lower prevalence of atopy among people with prior tuberculosis on univariate analysis (odds ratio 0.57; 95% confidence interval 0.37-0.88) but, after adjustment for potential confounders, this was no longer statistically significant (aOR 0.64, 95% CI 0.41-1.01). The prevalence of allergic rhinitis (aOR 0.76, 95% CI 0.47 to 1.24 and asthma (aOR 1.18, 95% CI 0.69 to 2.00) did not differ significantly between the two groups. We also found no significant difference in the prevalence of elevated exhaled nitric oxide (aOR 1.30, 95% CI 0.78 to 2.17) or a combined index of atopic disease (aOR 0.86, 95% CI 0.54 to 1.36).

CONCLUSION:

In this urban environment in a middle-income country, prior tuberculosis may be associated with a reduced risk of atopy but does not protect against asthma and atopic disease.

KEYWORDS:

Allergy; Asthma; Atopy; Immune response; Peru; Tuberculosis

PMID:
30760258
PMCID:
PMC6373156
DOI:
10.1186/s12890-019-0804-z
[Indexed for MEDLINE]
Free PMC Article

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