Recurrent TB: a systematic review and meta-analysis of the incidence rates and the proportions of relapses and reinfections.
Recurrent TB: a systematic review and meta-analysis of the incidence rates and the proportions of relapses and reinfections.
复制标题
复发性结核病：对发病率以及复发和再感染比例的系统回顾和荟萃分析。
DOI：
10.1136/thoraxjnl-2020-215449
复制
发表时间：
2021-05
期刊：
影响因子：
10
通讯作者：
Otero L
中科院分区：
文献类型：
--
作者：
Vega V;Rodríguez S;Van der Stuyft P;Seas C;Otero L
复发性结核病(TB)是由外源性再感染或治愈后复发所致。基因分型的使用允许两者之间的区别。我们利用MEDLINE、Lilacs/Scielo和Cochrane搜索在1980年1月1日至2020年9月30日期间发表的英语、法语和西班牙语研究，对治疗成功后的复发和/或通过基因分型区分复发和/或再感染的复发进行了系统的综述和荟萃分析。我们计算了随访的人-年，并进行了随机效应模型荟萃分析，以估计合并的复发结核病发病率以及复发和再感染的比例。我们根据临床流行病学因素和方法学研究特点进行亚组分析。合并复发结核病发病率为2.26/100个高危人群年(95%可信区间为1.87-2.73；145项研究)。异质性高(I2=98%)。在低和高结核病发病率环境下进行的研究中，分层合并复发率从每100人年1.47(95%可信区间0.87-2.46)增加到4.10(95%可信区间2.67-6.28)。背景HIV流行率、治疗药物方案、样本量和随访时间也是影响因素。复发率为70%(95%可信区间63-77%；I2=85%；48项研究)。异质性是由背景结核病发病率确定的，在低结核病发病率和高结核病发病率的研究中，复发率分别为83%(95%可信区间75-%)和59%(95%可信区间42-74%)。结核病复发的风险很大，复发一直是最常见的复发形式。尽管如此，随着背景结核病发病率的增加，再感染的比例增加，复发在复发中的优势减少。CRD42018077867
A recurrent tuberculosis (TB) episode results from exogenous reinfection or relapse after cure. The use of genotyping allows the distinction between both. We did a systematic review and meta-analysis, using a MEDLINE, Lilacs/Scielo, and Cochrane search for studies in English, French, and Spanish published between January 1, 1980 andSeptember 30, 2020 that assessed recurrences after treatment success and/or differentiated relapses from reinfections using genotyping. We calculated person-years of follow- up and performed random-effects model meta-analysis for estimating pooled recurrent TB incidence rates and proportions of relapses and reinfections. We performed subgroup analysis by clinical-epidemiological factors and by methodological study characteristics. The pooled recurrent TB incidence rate was 2.26 per 100 person-years at risk (95%CI 1.87–2.73; 145 studies). Heterogeneity was high (I2=98%). Stratified pooled recurrence rates increased from 1.47 (95%CI 0.87–2.46) to 4.10 (95%CI 2.67–6.28) per 100 person-years for studies conducted in low vs. high TB incidence settings. Background HIV prevalence, treatment drug regimen, sample size and duration of follow-up contributed too. The pooled proportion of relapses was 70% (95%CI 63–77%; I2=85%; 48 studies). Heterogeneity was determined by background TB incidence, as demonstrated by pooled proportions of 83% (95%CI 75–89%) vs 59% (95%CI 42–74%) relapse for studies from settings with low vs. high TB incidence, respectively. The risk of recurrent TB is substantial and relapse is consistently the most frequent form of recurrence. Notwithstanding, with increasing background TB incidence the proportion of reinfection increases and the predominance of relapses among recurrences decreases. CRD42018077867
登录
查看更多内容
DOI：
10.1164/rccm.200503-449oc
发表时间：
2005-09-01
影响因子：
24.7
作者：
van Rie, A;Victor, TC;Warren, RM
通讯作者：
Warren, RM
DOI：
10.1093/infdis/jix387
发表时间：
2017-11-06
期刊：
The Journal of infectious diseases
影响因子：
--
作者：
Hanson CL;Osberg M;Brown J;Durham G;Chin DP
通讯作者：
Chin DP
影响因子：
6.4
作者：
Chin, Daniel P.;Hanson, Christy L.
通讯作者：
Hanson, Christy L.
影响因子：
3.7
作者：
Velayutham B;Chadha VK;Singla N;Narang P;Gangadhar Rao V;Nair S;Ramalingam S;Narayanan Sivaramakrishnan G;Joseph B;Selvaraju S;Shanmugam S;Narang R;Pachikkaran P;Bhat J;Ponnuraja C;Bajaj Bhalla B;Shivashankara BA;Sebastian G;Yadav R;Kumar Sharma R;Sarin R;Myneedu VP;Singla R;Khayyam K;Mrithunjayan SK;Jayasankar SP;Sanker P;Viswanathan K;Viswambharan R;Mathuria K;Bhalla M;Singh N;Tumane KB;Dawale A;Tiwari CP;Bansod R;Jayabal L;Murali L;Khaparde SD;Rao R;Jawahar MS;Natrajan M
通讯作者：
Natrajan M
影响因子：
24.3
作者：
Dobler, C. C.;Crawford, A. B. H.;Marks, G. B.
通讯作者：
Marks, G. B.