The association between alcohol use, alcohol use disorders and tuberculosis (TB). A systematic review.
The association between alcohol use, alcohol use disorders and tuberculosis (TB). A systematic review.
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DOI：
10.1186/1471-2458-9-450
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发表时间：
2009-12-05
影响因子：
4.5
通讯作者：
Popova S
中科院分区：
文献类型：
--
作者：
Rehm J;Samokhvalov AV;Neuman MG;Room R;Parry C;Lönnroth K;Patra J;Poznyak V;Popova S
2004年，结核病占全球死亡率的2.5%（男性3.1%;女性1.8%），占全球疾病负担的2.2%（男性2.7%;女性1.7%）。目前的工作描绘了酒精消费和结核病之间的关联积累的证据，旨在澄清这种关系的性质。对关于饮酒与结核病之间关系的现有科学数据以及与澄清因果关系相关的研究进行了系统性审查。重度酒精使用/酒精使用障碍（AUD）与结核病之间存在密切联系。对这些因素的TB风险进行荟萃分析，得出合并相对风险为2.94（95%CI：1.89-4.59）。大量研究表明，酒精对免疫系统的致病影响导致酗酒者对结核病的易感性。此外，AUD和TB之间存在潜在的社会途径。大量饮酒强烈影响疾病的发生率和结果，并被发现与治疗结核病所用药物的药代动力学改变、社会边缘化和漂移、较高的再感染率、较高的治疗违约率和结核病耐药形式的发展有关。根据现有数据，估计全球约10%的结核病病例可归因于酒精。流行病学和其他证据表明，大量饮酒/AUD构成了结核病发病和再感染的风险因素。预防和临床干预的后果进行了讨论。
In 2004, tuberculosis (TB) was responsible for 2.5% of global mortality (among men 3.1%; among women 1.8%) and 2.2% of global burden of disease (men 2.7%; women 1.7%). The present work portrays accumulated evidence on the association between alcohol consumption and TB with the aim to clarify the nature of the relationship. A systematic review of existing scientific data on the association between alcohol consumption and TB, and on studies relevant for clarification of causality was undertaken. There is a strong association between heavy alcohol use/alcohol use disorders (AUD) and TB. A meta-analysis on the risk of TB for these factors yielded a pooled relative risk of 2.94 (95% CI: 1.89-4.59). Numerous studies show pathogenic impact of alcohol on the immune system causing susceptibility to TB among heavy drinkers. In addition, there are potential social pathways linking AUD and TB. Heavy alcohol use strongly influences both the incidence and the outcome of the disease and was found to be linked to altered pharmacokinetics of medicines used in treatment of TB, social marginalization and drift, higher rate of re-infection, higher rate of treatment defaults and development of drug-resistant forms of TB. Based on the available data, about 10% of the TB cases globally were estimated to be attributable to alcohol. The epidemiological and other evidence presented indicates that heavy alcohol use/AUD constitute a risk factor for incidence and re-infection of TB. Consequences for prevention and clinical interventions are discussed.
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影响因子：
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