HLA-DQ B1*0201 and A1*0102 Alleles Are Not Responsible for Antituberculosis Drug-Induced Hepatotoxicity Risk in Spanish Population.

AIMS: To evaluate the role of human leukocyte antigen (HLA) class II DQB1*0201 and DQA1*0102 in the risk of antituberculosis drug (ATD)-induced hepatotoxicity (ATDH) in a cohort of tuberculosis patients of Caucasian origin from Spain. METHODS: Matched case-control study including active tuberculosis (TB) patients from Spain (Caucasian) treated with first-line ATD (Isoniazid, Rifampin, and Pyrazinamide). Presence or absence of HLA class II DQB1*0201 and DQA1*0102 alleles were compared between cases and controls. RESULTS: We included 110 TB patients, 55 ATDH cases, and 55 sex-matched controls. The analysis of the presence of HLA-DQB1*0201 and HLA-DQA*0102 did not show significative differences between both groups [presence of HLA-DQB1*0201 53.6% of the cases vs. 45.4% of the controls, OR: 1.63 95% CI (0.62-4.52) p = 0.38; presence of HLA-DQA*0102 7.5% of cases vs. 20% of controls, OR: 0.36 95% CI (0.08-1.23) p = 0.12]. After multivariate logistic regression analysis including in the model, other potential risk factors of hepatotoxicity HLA class II DQB1*0201 and DQA1*0102 alleles were not found significantly associated with the risk of development ATDH. We could not demonstrate an association between HLA-DQA1*0102 and HLA-DQB1*0201 with the risk of ATDH in this Caucasian population of Spanish origin.

Significado clínico de las micobacterias ambientales aisladas en muestras respiratorias en pacientes con silicosis y sin silicosis / Clinical Significance of Environmental Mycobacteria Isolated From Respiratory Specimens of Patients With and Without Silicosis

Objetivo: Describir las diferencias clínicas, funcionales y radiográficas de la enfermedad respiratoria por micobacterias ambientales (MA) en pacientes con silicosis y sin silicosis. Método: Estudio observacional retrospectivo en pacientes a los que se les había aislado una micobacteria no tuberculosa en el laboratorio de Microbiología del hospital de O Meixoeiro (CHU de Vigo) desde enero 2007 hasta diciembre 2013. Se diferenció a los pacientes según presentaran o no silicosis y enfermedad pulmonar por MA utilizando los criterios de la American Thoracic Society. Resultados: Se identificaron 156 casos con aislamiento respiratorio de al menos una especie de MA. El 71% eran varones, de los cuales 40 (25,6%) tenían silicosis. En 60 pacientes (38,5%), el 62,5% del grupo de silicosis y el 30,2% del grupo sin silicosis, se cumplían los criterios microbiológicos recomendados por la American Thoracic Society siendo las especies más comunes Mycobacterium avium complex, Mycobacterium genavense y Mycobacterium chelonae. En 34 pacientes (22,7%), 14 del grupo de silicosis y 20 del grupo sin silicosis, se cumplían los criterios de la American Thoracic Society de enfermedad pulmonar por MA. Se realizó tratamiento en 24 casos, con mayores niveles de erradicación bacteriológica en el grupo sin silicosis. Conclusiones: En nuestros pacientes el antecedente de silicosis se relacionó con mayor incidencia de enfermedad por MA. La especie causante de la mayor parte de los casos de de enfermedad en nuestro medio por MA es Mycobacterium avium complex, seguido de Mycobacterium genavense. Los pacientes con silicosis presentaron menores niveles de curación tras el tratamiento

Objective: To describe the clinical, functional and radiographic differences of respiratory disease caused by environmental mycobacteria (EM) in patients with and without silicosis. Method: Retrospective, observational study in patients with nontuberculous mycobacteria isolated in the Hospital Meixoeiro (University Hospital of Vigo) microbiology laboratory between January 2007 and December 2013. Patients were grouped according to the presence or absence of silicosis and mycobacterial lung disease, using American Thoracic Society criteria. Results: In 156 cases, at least one species of EM had been isolated from the respiratory culture. A total of 71% were identified in men, 40 (25.6%) of whom had silicosis. Sixty patients (38.5%) met American Thoracic Society microbiological criteria: 62.5% of the silicosis group and 30.2% of the non-silicosis group. The most common species were Mycobacterium avium complex, Mycobacterium genavense and Mycobacterium chelonae. American Thoracic Society criteria for environmental mycobacterial disease were met in 34 (22.7%) patients: 14 in the silicosis group and 20 in the non-silicosis group. Treatment was administered in 24 cases, with better bacteriological eradication levels in the non-silicosis group. Conclusions: In our series, a history of silicosis was related with a higher incidence of environmental mycobacterial disease. The causative species in the majority of cases in our setting wasMycobacterium avium complex, followed by Mycobacterium genavense. Patients with silicosis showed lower cure rates after treatment

Clinical Significance of Environmental Mycobacteria Isolated From Respiratory Specimens of Patients With and Without Silicosis.

OBJECTIVE: To describe the clinical, functional and radiographic differences of respiratory disease caused by environmental mycobacteria (EM) in patients with and without silicosis. METHOD: Retrospective, observational study in patients with nontuberculous mycobacteria isolated in the Hospital Meixoeiro (University Hospital of Vigo) microbiology laboratory between January 2007 and December 2013. Patients were grouped according to the presence or absence of silicosis and mycobacterial lung disease, using American Thoracic Society criteria. RESULTS: In 156 cases, at least one species of EM had been isolated from the respiratory culture. A total of 71% were identified in men, 40 (25.6%) of whom had silicosis. Sixty patients (38.5%) met American Thoracic Society microbiological criteria: 62.5% of the silicosis group and 30.2% of the non-silicosis group. The most common species were Mycobacterium avium complex, Mycobacterium genavense and Mycobacterium chelonae. American Thoracic Society criteria for environmental mycobacterial disease were met in 34 (22.7%) patients: 14 in the silicosis group and 20 in the non-silicosis group. Treatment was administered in 24 cases, with better bacteriological eradication levels in the non-silicosis group. CONCLUSIONS: In our series, a history of silicosis was related with a higher incidence of environmental mycobacterial disease. The causative species in the majority of cases in our setting was Mycobacterium avium complex, followed by Mycobacterium genavense. Patients with silicosis showed lower cure rates after treatment.

[Factors predicting new tuberculosis infections and tuberculin conversions in a contact tracing system]. / Factores predictores de la aparición de nuevos casos de infección tuberculosa y de viraje tuberculínico en un estudio de contactos.

OBJECTIVE: To study new cases of latent tuberculosis (TB) infection, active TB and tuberculin conversions detected by means of a system for tracing the contacts of TB patients and to analyze the factors that predict the appearance of new cases. METHOD: We performed a longitudinal, prospective study of all contacts of patients with active TB in the health district of Vigo, Pontevedra, in 2005 and 2006. The total rate of positive tuberculin test results and the percentage of tuberculin conversions at the end of the study were analyzed. The predictive factors for positive results were identified by a multivariate analysis. RESULTS: A total of 742 contacts of patients with TB were studied. The mean age of contacts was 35 years (SD=19.1) and 406 (54.7%) were women. Most (91.8%) were contacts of pulmonary TB patients, 70.4% were contacts of bacilliferous patients and 40.2% were highly exposed. The study was completed with 540 (72.8%) cases, 280 (51.9%) of which were infected or diseased. Of the 297 contacts who completed the study 12 weeks later, 37 (12.5%) showed tuberculin conversion. The factors independently associated with a positive tuberculin test result were male sex, age >or= 30 years old, and degree of contact (high exposure in contacts and positive sputum smear in the index case); the two latter factors were predictive for tuberculin conversion. CONCLUSION: Contact tracing of TB patients was an effective strategy in our area. The factors most closely related to positive tuberculin test results, particularly to conversion, were positive direct microscopy of sputum for the index case and high exposure. Strategies to improve adherence to this kind of study should be sought.

Factores predictores de la aparición de nuevos casos de infección tuberculosa y de viraje tuberculínico en un estudio de contactos / Factors predicting new tuberculosis infections and tuberculin conversions in a contact tracing system

Objetivo. Examinar la aparición de nuevos casos de infección tuberculosa latente, tuberculosis activa y virajes tuberculínicos detectados mediante un estudio de contactos (EC) de pacientes con tuberculosis (TB) y analizar los factores que predicen su aparición. Método. Estudio prospectivo, longitudinal, que incluyó a todos los contactos de casos con TB activa del área sanitaria de Vigo (Pontevedra) durante 2005 y 2006. Se analizó la tasa total de pruebas de tuberculina (PT) positivas y el porcentaje de virajes tuberculínicos al final del EC. Mediante un análisis multivariante se observó cuáles fueron los factores predictivos de dichos resultados. Resultados. Se estudiaron 742 contactos de pacientes con TB, con una edad media de 35 (desviación estándar = 19,1) años, 406 (54,7%) mujeres. El 91,8% fue contacto de enfermos con TB pulmonar, el 70,4% contacto de enfermos bacilíferos y el 40,2% tenía contacto íntimo. Completaron el estudio 540 pacientes (72,8%), de los cuales estaban infectados o enfermos 280 (51,9%).De los 297 que completaron el estudio a las 12 semanas, 37 (12,5%) presentaron un viraje tuberculínico. Los factores que se asociaron de forma independiente con un resultado positivo de la PT fueron el sexo masculino, la edad $ 30 años y la intensidad del contacto íntima por parte de los contactos, y la baciloscopia positiva por parte del caso índice, siendo estos 2 últimos factores los que predicen la conversión. Conclusión. El EC de enfermos con TB es una estrategia eficaz en nuestro medio. Los factores que se correlacionan de forma más importante con presentar una PT positiva, sobre todo con la conversión, son la microscopia directa de esputo positiva del caso índice y el contacto íntimo. Es importante buscar estrategias que permitan mejorar la adhesión a este tipo de estudios

Objective. To study new cases of latent tuberculosis (TB) infection, active TB and tuberculin conversions detected by means of a system for tracing the contacts of TB patients and to analyze the factors that predict the appearance of new cases. Method. We performed a longitudinal, prospective study of all contacts of patients with active TB in the health district of Vigo, Pontevedra, in 2005 and 2006. The total rate of positive tuberculin test results and the percentage of tuberculin conversions at the end of the study were analyzed. The predictive factors for positive results were identified by a multivariate analysis. Results. A total of 742 contacts of patients with TB were studied. The mean age of contacts was 35 years (SD = 19.1) and 406 (54.7%) were women. Most (91.8%) were contacts of pulmonary TB patients, 70.4% were contacts of bacilliferous patients and 40.2% were highly exposed. The study was completed with 540 (72.8%) cases, 280 (51.9%) of which were infected or diseased. Of the 297 contacts who completed the study 12 weeks later, 37 (12.5%) showed tuberculin conversion. The factors independently associated with a positive tuberculin test result were male sex, age $ 30 years old, and degree of contact (high exposure in contacts and positive sputum smear in the index case); the two latter factors were predictive for tuberculin conversion. Conclusion. Contact tracing of TB patients was an effective strategy in our area. The factors most closely related to positive tuberculin test results, particularly to conversion, were positive direct microscopy of sputum for the index case and high exposure. Strategies to improve adherence to this kind of study should be sought