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{{Tuberculosis}}
{{Tuberculosis}}
{{CMG}}; {{AE}} {{JS}}
{{CMG}}; {{AE}} {{Mashal Awais}}; {{JS}}


==Overview==
==Overview==
The [[risk factor]]s for the development of [[tuberculosis]] include: traveling or living in areas endemic for TB, immunosuppression (patients taking [[immunosuppressive]] medication or with [[immunosuppressive]] diseases, such as [[HIV]] or [[diabetes]]); history of contact with [[infected]] patients, bad hygiene conditions, and evidence of previous tuberculosis.
The [[risk factor]]s for developing [[tuberculosis]] include: living or traveling to [[Endemic (epidemiology)|endemic]] areas for TB, elderly people and infants, [[immunosuppression]], history of frequent or prolonged contact with [[infected]] patients, IV drug users, [[smoking]], bad [[hygiene]], and poor [[nutrition]]. In addition, the [[Risk factor|risk factors]] for [[multidrug-resistant TB]] include: [[non-adherence]] to [[treatment]] [[regimen]], inadequate [[treatment]] for that [[Bacteria|bacterial]] [[strain]], and [[Contact dermatitis|contact]] with patients with [[multidrug-resistant TB]].
Risk factors for [[multidrug-resistant TB]] include: non-adherence to treatment regimen, inadequate medication for that [[strain]] of [[bacteria]], and contact with patients with [[multidrug-resistant TB]].


==Risk Factors==
==Risk Factors==
Primary [[TB]] disease (1-5% cases) occurs soon after [[infection]], however, the majority of cases occur with latent infection, where there are no obvious [[symptoms]]. The dormant [[bacilli]] can cause [[tuberculosis]] in 2 to 23% of the latent cases, often many years after initial [[infection]].<ref name=Parrish_1998>{{cite journal |author=Parrish N, Dick J, Bishai W |title=Mechanisms of latency in Mycobacterium tuberculosis |journal=Trends Microbiol |volume=6 |issue=3 |pages=107-12 |year=1998 | pmid = 9582936}}</ref> The risk of reactivation increases with [[immunosuppression]], such as that caused by [[infection]] with [[HIV]]. In patients co-infected with [[HIV]], the risk of reactivation increases to 10% per year.
Primary [[TB]], which represents 1-5% cases, occurs after [[infection]]. However, most of the cases occur with latent [[infection]] which is [[asymptomatic]]. The [[dormant]] [[bacilli]] can cause [[tuberculosis]] in 2 to 23% of the latent cases, usually several years following the primary [[infection]].<ref name="Parrish_1998">{{cite journal |author=Parrish N, Dick J, Bishai W |title=Mechanisms of latency in Mycobacterium tuberculosis |journal=Trends Microbiol |volume=6 |issue=3 |pages=107-12 |year=1998 | pmid = 9582936}}</ref> The risk of [[reactivation]] is much higher with [[immunosuppression]], such as [[HIV]]. In patients with [[HIV]] coinfection, the risk of [[reactivation]] increases reaching up to 10% per year.


''The following are risk factors for active [[TB]]:''<ref name=CDC>{{cite web | title = Tuberculosis Fact Sheet | url = http://www.cdc.gov/tb/publications/factsheets/drtb/mdrtb.htm }}</ref><ref name=Griffith_1996>{{cite journal |author=Griffith D, Kerr C |title=Tuberculosis: disease of the past, disease of the present |journal=J Perianesth Nurs |volume=11 |issue=4 |pages=240-5 |year=1996 | pmid = 8964016}}</ref>
''The following are [[Risk factor|risk factors]] for active [[TB]]:''<ref name="CDC">{{cite web | title = Tuberculosis Fact Sheet | url = http://www.cdc.gov/tb/publications/factsheets/drtb/mdrtb.htm }}</ref><ref name="Griffith_1996">{{cite journal |author=Griffith D, Kerr C |title=Tuberculosis: disease of the past, disease of the present |journal=J Perianesth Nurs |volume=11 |issue=4 |pages=240-5 |year=1996 | pmid = 8964016}}</ref>
* Traveling or living in endemic regions (Sub-saharan African, Russia, India, Pakistan, China)
* Elderly
* Infants
* IV drug users
* Immunosuppression:
:* [[AIDS]]
:* [[Diabetes]]
:* [[Silicosis]]
:* [[Malignancy]], such as head and neck cancers
* [[hematology|Hematologic]] and [[Reticuloendothelial system|reticuloendothelial]] disease, such as [[leukemia]] and [[Hodgkin's disease]]
:* [[End-stage kidney disease]]
:* History of [[gastrectomy]]
:* [[Malabsorption syndrome]]
* Or those taking medications, such as:
:* [[Chemotherapy]]
:* [[Immunosuppressive]] medications, such as prolonged [[corticosteroid]] therapy, [[tumor necrosis factor-alpha]] blockers<ref name=Mutlu_2006>{{cite journal |author=Mutlu G, Mutlu E, Bellmeyer A, Rubinstein I |title=Pulmonary adverse events of anti-tumor necrosis factor-alpha antibody therapy |journal=Am J Med |volume=119 |issue=8 |pages=639-46 |year=2006 | pmid = 16887405}}</ref>
:* [[Tocilizumab]]


''The risk of contracting [[TB]] increases in cases where there is:''<ref name=CDC>{{cite web | title = Tuberculosis Fact Sheet | url = http://www.cdc.gov/tb/publications/factsheets/drtb/mdrtb.htm }}</ref>
*Living or traveling to [[Endemic (epidemiology)|endemic]] areas (Sub-saharan African, Russia, India, Pakistan, China)
* Frequent contact with people who have [[TB]]
*[[Old age|Elderly]]
* Poor [[nutrition]]
*[[Infant|Infants]]
* Smoking
*[[IV drug users]]
* Bad hygiene  
*[[Immunosuppression]]:
 
:*[[AIDS]]
:*[[Diabetes]]
:*[[Silicosis]]
:*[[Malignancy]], such as head and neck [[Cancer|cancers]]
 
*[[hematology|Hematologic]] and [[Reticuloendothelial system|reticuloendothelial]] disease, such as [[leukemia]] and [[Hodgkin's disease]]
 
:*[[End-stage kidney disease]]
:*History of [[gastrectomy]]
:*[[Malabsorption syndrome]]
 
*Or those taking medications, such as:
 
:*[[Chemotherapy]]
:*[[Immunosuppressive]] medications, such as prolonged [[corticosteroid]] therapy, [[tumor necrosis factor-alpha]] blockers<ref name="Mutlu_2006">{{cite journal |author=Mutlu G, Mutlu E, Bellmeyer A, Rubinstein I |title=Pulmonary adverse events of anti-tumor necrosis factor-alpha antibody therapy |journal=Am J Med |volume=119 |issue=8 |pages=639-46 |year=2006 | pmid = 16887405}}</ref>
:*[[Tocilizumab]]
 
''The risk of contracting [[TB]] increases in cases where there is:''<ref name="CDC">{{cite web | title = Tuberculosis Fact Sheet | url = http://www.cdc.gov/tb/publications/factsheets/drtb/mdrtb.htm }}</ref>
 
*Frequent or prolonged contact with people who have [[TB]]
*Poor [[nutrition]]
*[[Smoking]]
*Bad hygiene
 
The following factors may increase the rate of [[TB]] [[infection]] in a population:<ref name="CDC">{{cite web | title = Tuberculosis Fact Sheet | url = http://www.cdc.gov/tb/publications/factsheets/drtb/mdrtb.htm }}</ref>
 
*[[Chest X-ray]] with evidence of previous [[TB]] disease (fibrotic lesions and nodules)
*Increased number of [[HIV]] infections
*Increased number of [[homeless]] people
*The appearance of [[drug-resistant]] [[Strain (biology)|strains]] of [[TB]]


The following factors may increase the rate of [[TB]] [[infection]] in a population:<ref name=CDC>{{cite web | title = Tuberculosis Fact Sheet | url = http://www.cdc.gov/tb/publications/factsheets/drtb/mdrtb.htm }}</ref>
* [[Chest X-ray]] with evidence of previous [[TB]] disease (fibrotic lesions and nodules)
* Increased number of [[HIV]] infections
* Increased number of homeless people
* The appearance of [[drug-resistant]] strains of [[TB]]
==Drugs With Increased Risk of Tuberculosis Reactivation==
==Drugs With Increased Risk of Tuberculosis Reactivation==
* Treatment with the following drugs have been reported with increased risk of reactivation of latent tuberculosis.
 
:* [[Adalimumab]]
*Treatment with the following [[:Category:Drugs|drugs]] have been reported with increased risk of reactivation of [[latent tuberculosis]].
:* [[Alemtuzumab]]
 
:* [[Belatacept]]
:*[[Adalimumab]]
:* [[Certolizumab pegol]]
:*[[Alemtuzumab]]
:* [[Canakinumab]]
:*[[Belatacept]]
:* [[Etanercept]]
:*[[Certolizumab pegol]]
:* [[Fluocortolone]]
:*[[Canakinumab]]
:* [[Golimumab]]
:*[[Etanercept]]
:* [[Infliximab]]
:*[[Fluocortolone]]
:* [[Rilonacept]]
:*[[Golimumab]]
:* [[Ruxolitinib]]
:*[[Infliximab]]
:* [[Saxagliptin]]
:*[[Rilonacept]]
:* [[Teriflunomide]]
:*[[Ruxolitinib]]
:* [[Tocilizumab]]
:*[[Saxagliptin]]
:* [[Tofacitinib]]
:*[[Teriflunomide]]
:*   Vedolizumab
:*[[Tocilizumab]]
:*[[Tofacitinib]]
:*Vedolizumab


===Multidrug-Resistant Tuberculosis===
===Multidrug-Resistant Tuberculosis===
[[Drug resistance]] is more common in people who:<ref name=WHO>{{cite web | title = Multidrug-resistant tuberculosis | url = http://www.who.int/tb/challenges/mdr/en/ }}</ref>
[[Drug resistance]] is more common in people who:<ref name="WHO">{{cite web | title = Multidrug-resistant tuberculosis | url = http://www.who.int/tb/challenges/mdr/en/ }}</ref>
* Do not take their [[TB]] medicine regularly
 
* Do not take all of their [[TB]] medicine as told by their doctor or nurse
*Do not take their [[TB]] medicine regularly
* Develop [[TB]] disease again, after having taken [[TB]] medicine in the past
*Do not take all of their [[TB]] medicine as told by their doctor or nurse
* Come from areas of the world where [[drug-resistant]] [[TB]] is common
*Develop [[TB]] disease again, after having taken [[TB]] medicine in the past
* Have spent time with someone known to have [[drug-resistant]] [[TB]] disease
*Come from areas of the world where [[drug-resistant]] [[TB]] is common
*Have spent time with someone known to have [[drug-resistant]] [[TB]] disease


==References==
==References==
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[[Category:Bacterial diseases]]
[[Category:Bacterial diseases]]
[[Category:Disease]]
[[Category:Disease]]
[[Category:Pulmonology]]
[[Category: Pulmonology]]

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Mashal Awais, M.D.[2]; João André Alves Silva, M.D. [3]

Overview

The risk factors for developing tuberculosis include: living or traveling to endemic areas for TB, elderly people and infants, immunosuppression, history of frequent or prolonged contact with infected patients, IV drug users, smoking, bad hygiene, and poor nutrition. In addition, the risk factors for multidrug-resistant TB include: non-adherence to treatment regimen, inadequate treatment for that bacterial strain, and contact with patients with multidrug-resistant TB.

Risk Factors

Primary TB, which represents 1-5% cases, occurs after infection. However, most of the cases occur with latent infection which is asymptomatic. The dormant bacilli can cause tuberculosis in 2 to 23% of the latent cases, usually several years following the primary infection.[1] The risk of reactivation is much higher with immunosuppression, such as HIV. In patients with HIV coinfection, the risk of reactivation increases reaching up to 10% per year.

The following are risk factors for active TB:[2][3]

  • Or those taking medications, such as:

The risk of contracting TB increases in cases where there is:[2]

The following factors may increase the rate of TB infection in a population:[2]

Drugs With Increased Risk of Tuberculosis Reactivation

Multidrug-Resistant Tuberculosis

Drug resistance is more common in people who:[5]

  • Do not take their TB medicine regularly
  • Do not take all of their TB medicine as told by their doctor or nurse
  • Develop TB disease again, after having taken TB medicine in the past
  • Come from areas of the world where drug-resistant TB is common
  • Have spent time with someone known to have drug-resistant TB disease

References

  1. ↑ Parrish N, Dick J, Bishai W (1998). "Mechanisms of latency in Mycobacterium tuberculosis". Trends Microbiol. 6 (3): 107–12. PMID 9582936.
  2. ↑ 2.0 2.1 2.2 "Tuberculosis Fact Sheet".
  3. ↑ Griffith D, Kerr C (1996). "Tuberculosis: disease of the past, disease of the present". J Perianesth Nurs. 11 (4): 240–5. PMID 8964016.
  4. ↑ Mutlu G, Mutlu E, Bellmeyer A, Rubinstein I (2006). "Pulmonary adverse events of anti-tumor necrosis factor-alpha antibody therapy". Am J Med. 119 (8): 639–46. PMID 16887405.
  5. ↑ "Multidrug-resistant tuberculosis".

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