Investigation of the prevalence of latent tuberculosis in cancer patients compared to non-cancer patients: a case-control study

BackgroundLatent tuberculosis (TB) can reactivate in immunocompromised individuals, such as cancer patients undergoing chemotherapy, leading to severe complications. Understanding the prevalence of latent TB in this high-risk group is crucial, especially in regions with moderate to high TB burdens.A...

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Main Authors: Masoud Mortezazadeh, Mehdi Karimi, Mohsen Esfandbod, Abbas Mofidi, Nima Hemmati, Mehdi Kashani, Niyousha Shirsalimi, Seyyed Taher Seyyed Mahmoudi, Ehsan Kamali Yazdi
Format: Article
Language:English
Published: Frontiers Media S.A. 2024-12-01
Series:Oncology Reviews
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Online Access:https://www.frontiersin.org/articles/10.3389/or.2024.1445678/full
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author Masoud Mortezazadeh
Mehdi Karimi
Mohsen Esfandbod
Abbas Mofidi
Nima Hemmati
Mehdi Kashani
Niyousha Shirsalimi
Seyyed Taher Seyyed Mahmoudi
Ehsan Kamali Yazdi
author_facet Masoud Mortezazadeh
Mehdi Karimi
Mohsen Esfandbod
Abbas Mofidi
Nima Hemmati
Mehdi Kashani
Niyousha Shirsalimi
Seyyed Taher Seyyed Mahmoudi
Ehsan Kamali Yazdi
author_sort Masoud Mortezazadeh
collection DOAJ
description BackgroundLatent tuberculosis (TB) can reactivate in immunocompromised individuals, such as cancer patients undergoing chemotherapy, leading to severe complications. Understanding the prevalence of latent TB in this high-risk group is crucial, especially in regions with moderate to high TB burdens.AimThis study aims to determine the prevalence of latent tuberculosis in cancer patients before chemotherapy and immunotherapy to guide preventive interventions and reduce the risk of TB reactivation.MethodsThis case-control study was conducted at Sina Hospital in Tehran, Iran, from 2012 to 2022. A total of 392, including 107 newly diagnosed cancer (case) and 285 non-cancer (control) patients, were enrolled in this study. All patients had received the Bacillus Calmette-Guérin (BCG) vaccine at the age of one. They underwent a thorough clinical examination and were screened using the tuberculin skin test (TST) to detect latent TB. Any active TB cases were identified through acid-fast smear tests. The data collected from the study participants was then analyzed.ResultsThe results showed no significant difference in the size of TST between cancer and non-cancer patients (cases: median = 2 mm, IQR: 1–12; controls: median = 2 mm, IQR: 1–5; p = 0.09). The prevalence of latent TB was 27.1% in cancer patients and 20.7% in non-cancer patients, with no significant association identified between latent TB and malignancies (P-value = 0.176). Over a median follow-up of 4 years, mortality was significantly higher in cancer patients compared to controls (42.1% vs 1.8%; P< 0.001, OR = 40.64). Additionally, deceased patients exhibited a greater prevalence of latent TB (44% vs 19.3% in survivors; P< 0.001, OR = 3.28), and increased size of TST was associated with higher mortality risk among cancer patients.ConclusionIn conclusion, this study emphasizes the need for vigilant latent TB screening in cancer patients, given the association between larger TST sizes and increased mortality risk. While no direct link between cancer type and latent TB was found, proactive TB management remains crucial, particularly for those undergoing immunosuppressive therapy.
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spelling doaj-art-007904b16b674e62bf9dcd742584b2622024-12-04T09:24:16ZengFrontiers Media S.A.Oncology Reviews1970-55572024-12-011810.3389/or.2024.14456781445678Investigation of the prevalence of latent tuberculosis in cancer patients compared to non-cancer patients: a case-control studyMasoud Mortezazadeh0Mehdi Karimi1Mohsen Esfandbod2Abbas Mofidi3Nima Hemmati4Mehdi Kashani5Niyousha Shirsalimi6Seyyed Taher Seyyed Mahmoudi7Ehsan Kamali Yazdi8Department of Hematology-Oncology, Cancer Institute, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences (TUMS), Tehran, IranFaculty of Medicine, Bogomolets National Medical University (NMU), Kyiv, UkraineDepartment of Hematology-Oncology, Sina Hospital, Tehran University of Medical Sciences (TUMS), Tehran, IranMinimally Invasive Surgery Research Center (MISRC), Iran University of Medical Sciences (IUMS), Tehran, IranMinimally Invasive Surgery Research Center (MISRC), Iran University of Medical Sciences (IUMS), Tehran, IranFaculty of Medicine, Tehran University of Medical Sciences (TUMS), Tehran, IranFaculty of Medicine, Hamadan University of Medical Science (UMSHA), Hamadan, IranFaculty of Medicine, Tabriz University of Medical Sciences, Tabriz, IranFaculty of Medicine, Tehran University of Medical Sciences (TUMS), Tehran, IranBackgroundLatent tuberculosis (TB) can reactivate in immunocompromised individuals, such as cancer patients undergoing chemotherapy, leading to severe complications. Understanding the prevalence of latent TB in this high-risk group is crucial, especially in regions with moderate to high TB burdens.AimThis study aims to determine the prevalence of latent tuberculosis in cancer patients before chemotherapy and immunotherapy to guide preventive interventions and reduce the risk of TB reactivation.MethodsThis case-control study was conducted at Sina Hospital in Tehran, Iran, from 2012 to 2022. A total of 392, including 107 newly diagnosed cancer (case) and 285 non-cancer (control) patients, were enrolled in this study. All patients had received the Bacillus Calmette-Guérin (BCG) vaccine at the age of one. They underwent a thorough clinical examination and were screened using the tuberculin skin test (TST) to detect latent TB. Any active TB cases were identified through acid-fast smear tests. The data collected from the study participants was then analyzed.ResultsThe results showed no significant difference in the size of TST between cancer and non-cancer patients (cases: median = 2 mm, IQR: 1–12; controls: median = 2 mm, IQR: 1–5; p = 0.09). The prevalence of latent TB was 27.1% in cancer patients and 20.7% in non-cancer patients, with no significant association identified between latent TB and malignancies (P-value = 0.176). Over a median follow-up of 4 years, mortality was significantly higher in cancer patients compared to controls (42.1% vs 1.8%; P< 0.001, OR = 40.64). Additionally, deceased patients exhibited a greater prevalence of latent TB (44% vs 19.3% in survivors; P< 0.001, OR = 3.28), and increased size of TST was associated with higher mortality risk among cancer patients.ConclusionIn conclusion, this study emphasizes the need for vigilant latent TB screening in cancer patients, given the association between larger TST sizes and increased mortality risk. While no direct link between cancer type and latent TB was found, proactive TB management remains crucial, particularly for those undergoing immunosuppressive therapy.https://www.frontiersin.org/articles/10.3389/or.2024.1445678/fulltuberculosisinfectious diseasecancertuberculin skin testMycobacteriumoncology
spellingShingle Masoud Mortezazadeh
Mehdi Karimi
Mohsen Esfandbod
Abbas Mofidi
Nima Hemmati
Mehdi Kashani
Niyousha Shirsalimi
Seyyed Taher Seyyed Mahmoudi
Ehsan Kamali Yazdi
Investigation of the prevalence of latent tuberculosis in cancer patients compared to non-cancer patients: a case-control study
Oncology Reviews
tuberculosis
infectious disease
cancer
tuberculin skin test
Mycobacterium
oncology
title Investigation of the prevalence of latent tuberculosis in cancer patients compared to non-cancer patients: a case-control study
title_full Investigation of the prevalence of latent tuberculosis in cancer patients compared to non-cancer patients: a case-control study
title_fullStr Investigation of the prevalence of latent tuberculosis in cancer patients compared to non-cancer patients: a case-control study
title_full_unstemmed Investigation of the prevalence of latent tuberculosis in cancer patients compared to non-cancer patients: a case-control study
title_short Investigation of the prevalence of latent tuberculosis in cancer patients compared to non-cancer patients: a case-control study
title_sort investigation of the prevalence of latent tuberculosis in cancer patients compared to non cancer patients a case control study
topic tuberculosis
infectious disease
cancer
tuberculin skin test
Mycobacterium
oncology
url https://www.frontiersin.org/articles/10.3389/or.2024.1445678/full
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