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Tuberculosis infection may be underestimated among people taking corticosteroid pills

Date:
June 26, 2014
Source:
St. Michael's Hospital
Summary:
Tuberculosis infection among people taking corticosteroid pills may be underestimated, new research suggests. Current guidelines for what constitutes a positive TB skin test among corticosteroid pill users may not be capturing all those who are infected, says one respirologist, who adds that although taking corticosteroid pills was a risk factor for turning latent TB into active TB, those patients were screened less often for TB than others. They were also less likely to be prescribed TB-fighting drugs prophylactically.

Tuberculosis infection among people taking corticosteroid pills may be underestimated, new research suggests. Current guidelines for what constitutes a positive TB skin test among corticosteroid pill users may not be capturing all those who are infected, said Dr. Nicholas Vozoris, a respirologist in the Tuberculosis Program at St. Michael's Hospital.

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Previous research has shown that people who take corticosteroid pills, such as Prednisone, and have inhaled the TB bacteria, have an eight times higher risk of the bacteria becoming active than people who are not taking the drugs.

Dr. Vozoris said that would suggest they should be screened more often for TB infection.

However, an examination of more than 7,300 people in the U.S. National Health and Nutrition Examination Survey found this was not the case. The survey, a series of studies designed to assess the health and nutritional status of adults and children in the United States, is unique in that it combines interviews and physical examinations.

The findings were published today in the European Respiratory Journal.

He found that although taking corticosteroid pills was a risk factor for turning latent TB into active TB, those patients were screened less often for TB than others. They were also less likely to be prescribed TB-fighting drugs prophylactically.

Dr. Vozoris said that for the general population, producing a bump at least 10 millimetres in diameter following a TB skin test likely means that one has inhaled the TB bacteria. Current guidelines recommend that the bump be only five millimetres long if the patient is taking corticosteroid pills, but Dr. Vozoris said there is no evidence to support that is the correct cut-off. The study results show that 3.5-mm might be a more appropriate cut-off.

Corticosteroid pills are commonly prescribed for people with asthma, chronic obstructive pulmonary disease, inflammatory bowel disease, inflammatory arthritis and cancer. They work by decreasing inflammation, but they also suppress the immune system.


Story Source:

The above story is based on materials provided by St. Michael's Hospital. The original article was written by Leslie Shepherd. Note: Materials may be edited for content and length.


Journal Reference:

  1. Nicholas T. Vozoris, Julie Seemangal, and Jane Batt. Prevalence, screening and treatment of latent tuberculosis among oral corticosteroid recipients. European Respiratory Journal, June 2014 DOI: 10.1183/09031936.00076714

Cite This Page:

St. Michael's Hospital. "Tuberculosis infection may be underestimated among people taking corticosteroid pills." ScienceDaily. ScienceDaily, 26 June 2014. <www.sciencedaily.com/releases/2014/06/140626101702.htm>.
St. Michael's Hospital. (2014, June 26). Tuberculosis infection may be underestimated among people taking corticosteroid pills. ScienceDaily. Retrieved November 25, 2014 from www.sciencedaily.com/releases/2014/06/140626101702.htm
St. Michael's Hospital. "Tuberculosis infection may be underestimated among people taking corticosteroid pills." ScienceDaily. www.sciencedaily.com/releases/2014/06/140626101702.htm (accessed November 25, 2014).

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