Possible sex difference in latent tuberculosis infection risk among close tuberculosis contacts
Year: 2022
Type: article
Abstract: Objectives More men than women develop and die of tuberculosis (TB). Fewer data exist on sex differences in latent TB infection (LTBI). We assessed for potential sex differences in LTBI acquisition among close TB contacts. Methods Regional Prospective Observational Research for TB-Brazil is an observational multi-center cohort of individuals with culture-confirmed pulmonary TB and their close contacts. Participants were enrolled from five sites in Brazil from June 2015 - June 2019. Close contacts were followed for 24 months after enrollment, with LTBI defined as a positive interferon-γ release assay (IGRA; QuantiFERON 3 rd or 4 th generation) at baseline or 6 months. We performed univariate, bivariate, and multivariable logistic regression and propensity-score weighted models to assess odds ratios (OR) and 95% confidence intervals (CI) for LTBI acquisition by birth sex among close contacts. Results Of 1093, 504 (46%) female close contacts were IGRA positive compared to 295 of 745 (40%) men. The unadjusted OR for IGRA positivity among women vs men was 1.31 (95% CI: 1.08-1.58). Bivariate adjustments yielded ORs in women vs men ranging from 1.19 to 1.33 ( P -value range: <0.01-0.07). Multivariable regression and weighted models yielded similar ORs in women vs men, of 1.14 (95% CI: 0.92-1.41) and 1.15 (95% CI: 0.94-1.40), respectively. Conclusion The point estimate for LTBI among close TB contacts in Brazil was higher in women, though less pronounced in multivariable models. If the sex difference in LTBI is confirmed in additional settings, studies of possible underlying differences in socio-behavioral factors or TB pathogenesis are warranted.
Institutions: Vanderbilt University, Fundação de Medicina Tropical, Universidade do Estado do Amazonas, Instituto Gonçalo Moniz, Fundação Oswaldo Cruz, Vanderbilt University Medical Center, Instituto Nacional de Infectologia Evandro Chagas, Universidade Federal do Rio de Janeiro, Universidade Nilton Lins, Universidade Federal da Bahia, Escola Bahiana de Medicina e Saúde Pública, Faculdade de Tecnologia e Ciências, Universidade Salvador
Language: English
Subfield: Infectious Diseases
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $2,200
Awards: G1448565887, Immunogenetic predictors of active and incipient TB in HIV-negative and -positive close TB contacts, The HIV Care Continuum and Health Policy: Changes through Context and Geography, Regional Prospective Observational Research in Tuberculosis (RePORT) – Brazil Network, Caribbean, Central, and South America network for HIV Epidemiology (CCASAnet)
OpenAlex ID: W4285680668