Abstract
Introduction: Disseminated tuberculosis (DTB) is a severe form of tuberculosis (TB) that often requires hospitalization and is associated with a higher rate of insuccess.
Objectives: identify risk factors for DTB.
Methods: Case control study – all patients with DTB notified in the national Tuberculosis Vigilance System between 2008-2012 in four centers of TB in Northern Portugal were identified and included in the study. Controls were randomly selected from pulmonary tuberculosis (PTB) patients diagnosed at the same centers, in the same period, with no exclusion criteria. A questionnaire was filled after review of clinical records. DTB was defined: involvement of more than two non-contiguous organs or identification of Mycobacterium tuberculosis in blood or bone marrow. Liver disease: infectious hepatitis B/C and alcohol liver disease. Univariate and multivariate analysis were performed to identify determinants associated with higher risk of DTB.
Results: 54 cases of DTB and 89 of PTB were included. Compared to PTB patients, more DTB patients had comorbidities (85.2% Vs 37.9%, p ≤0.001). Univariate analysis showed association between DTB and HIV (p≤0.001), liver disease (p≤0.001), alcohol abuse (p=0.001) and drug dependence (p≤0.001). The multiple logistic regression model indicated that HIV (p≤0.001) and liver disease (p=0.002) were significant risk factors for DTB. Treatment toxicity was higher (34.0%Vs16.9%, p=0.04) and success rate lower (72.2%Vs89.9%, p=0.012) in DTB patients.
Conclusions: Being HIV-positive or having liver disease determined a higher risk for developing disseminated disease.
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