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• W4386449346 abstract "Abstract Background: Transplant recipients are immunocompromised and vulnerable to developing tuberculosis; however, active tuberculosis incidence is rapidly declining in South Korea. To evaluate the risk of developing active tuberculosis after transplantation, risk factors for tuberculosis and standardized incidence rates were compared with those in the general population. Methods: This retrospective study was conducted based on the South Korean health insurance review and assessment database among those underwent transplantation (62,484 recipients) between 2008 and 2020. Tuberculosis incidence was compared in recipients treated during higher (2010–2012) and lower disease burden (2016–2018) periods. Standardized incidence ratios were analyzed using the Korean Tuberculosis Surveillance System. The primary outcome was the number of new tuberculosis cases after transplantation. Results: Of 57,103 recipients analyzed, the overall cumulative incidence rate 1 year after transplantation was 0.8% (95% confidence interval [CI]: 0.7–0.8), significantly higher in the higher-burden than in the lower-burden period (1.7% vs. 1.0% 3 years after transplantation, P < 0.001). Allogeneic hematopoietic stem cell transplantation had the highest tuberculosis incidence, followed by solid organ transplantation and autologous hematopoietic stem cell transplantation ( P < 0.001). The overall standardized incidence ratio was 3.9 (95% CI: 3.7–4.2) and was highest in children aged 0–19 years, at 9.0 (95% CI: 5.7–13.5). Male sex, older age, tuberculosis history, liver transplantation, and allogeneic hematopoietic stem cell transplantation were risk factors for tuberculosis. Conclusions: Transplant recipients are vulnerable to developing tuberculosis, possibly affected by immunocompromised status, solid organ transplant type, age, and community prevalence. Tuberculosis prevalence by country, transplant type, and age should be considered to establish an appropriate tuberculosis prevention strategy for high-risk groups." @default.
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• W4386449346 date "2023-09-06" @default.
• W4386449346 modified "2023-09-27" @default.
• W4386449346 title "Changes in tuberculosis risk after transplantation in the setting of decreased community tuberculosis incidence: a national population-based study, 2008–2020" @default.
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• W4386449346 doi "https://doi.org/10.21203/rs.3.rs-3313459/v1" @default.
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