Table 2.
Risk of tuberculosis (TB) among populations with conditions affecting immunity
| Population and definition of positive test result | Among test positive participants | Compared with test negative participants | ||||||||
|---|---|---|---|---|---|---|---|---|---|---|
| No of cohorts | No of participants | Total (mean) person years follow-up | Active TB events (%)* | TB rate per 1000 person years (95% CI)† | I2 (%) | No of cohorts | Incidence rate ratio (95% CI) | I2 (%) | ||
| General population‡: | ||||||||||
| TST ≥10 mm | 3 | 33 811 | 249 093 (7.4) | 55 (0.2) | 0.3 (0.1 to 1.1) | 96 | - | - | - | |
| Dialysis: | ||||||||||
| All IGRA positive | 4 | 375 | 871 (2.3) | 3 (0.8) | 3.4 (1.1 to 10.7) | 0 | 1 | 7.0 (0.7 to 67) | N/A | |
| TST ≥5 mm | 2 | 151 | 379 (2.5) | 10 (2.0) | 11.8 (0.7 to 200.7) | 59 | 1 | 1.5 (0.7 to 3.3) | N/A | |
| TST ≥10 mm | 3 | 129 | 253 (2.0) | 19 (14.7) | 100.6 (41.6 to 243.2) | 71 | 3 | 2.6 (1.4 to 4.8) | 0 | |
| HIV: | ||||||||||
| All IGRA positive | 9 | 573 | 1646 (2.9) | 28 (5.1) | 16.9 (10.5 to 27.3) | 29 | 7 | 11.0 (4.6 to 26.2) | 45 | |
| TST ≥5 mm | 9 | 1285 | 3782 (2.9) | 148 (7.1) | 27.1 (15.0 to 49.0) | 87 | 7 | 11.1 (6.2 to 19.9) | 46 | |
| Silicosis: | ||||||||||
| TST ≥10 mm | 2 | 352 | 1465 (4.2) | 54 (12.5) | 36.9 (28.2 to 48.1) | 0 | 1 | 1.7 (0.5 to 5.5) | N/A | |
| Transplant§: | ||||||||||
| All IGRA positive: | 9 | 481 | 993 (2.1) | 8 (1.6) | 6.7 (2.2 to 20.4) | 33 | 6 | 2.5 (1.0 to 6.0) | 0 | |
| TST ≥5 mm | 7 | 518 | 1716 (3.3) | 8 (0.1) | 1.0 (0 to 64) | 64 | 7 | 0.6 (0.1 to 3.0) | 30 | |
| TST ≥10 mm | 3 | 105 | 215 (2.0) | 5 (0.6) | 3.7 (0 to 861.5) | 88 | 3 | 2.4 (0.9 to 6.4) | 0 | |
| Immunosuppressants§: | ||||||||||
| All IGRA positive | 3 | 110 | 248 (2.3) | 4 (0.6) | 4.8 (0.1 to 279.2) | 73 | 1 | 48.1 (5.4 to 430.7) | N/A | |
| TST ≥5 mm | 5 | 212 | 551 (2.6) | 3 (1.4) | 5.4 (1.8 to 16.9) | 0 | 3 | 6.6 (1.8 to 24.2) | 0 | |
| Diabetes§: | ||||||||||
| All IGRA positive | 2 | 334 | 842 (2.5) | 4 (1.2) | 4.4 (0.9 to 22.0) | 8 | 1 | Not calculable | N/A | |
TST=tuberculin skin test; IGRA=interferon-gamma release assay; N/A=not applicable.
*
Percentage represents pooled cumulative incidence estimated from random effects meta-analysis.
†
Pooled estimates using random effects meta-analysis.
‡
Data provided for reference. Populations are from British Columbia and Saskatchewan, Canada, and Florida, USA.
§
See supplementary S1 for a further description of studies comprising these analyses.