Incidence and prevalence of tuberculosis in systemic lupus erythematosus patients: A systematic review and meta-analysis

BackgroundSystemic lupus erythematosus (SLE) patients are particularly susceptible to infections, such as pulmonary tuberculosis (PTB) and extrapulmonary tuberculosis (EPTB). This meta-analysis aimed to determine the incidence and prevalence of tuberculosis (TB) in SLE patients.MethodsThe Web of Sci...

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Main Authors: Qian Wu, Yang Liu, Wei Wang, Yu Zhang, Kui Liu, Song-Hua Chen, Bin Chen
Format: Article
Language:English
Published: Frontiers Media S.A. 2022-07-01
Series:Frontiers in Immunology
Subjects:
Online Access:https://www.frontiersin.org/articles/10.3389/fimmu.2022.938406/full
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author Qian Wu
Yang Liu
Wei Wang
Yu Zhang
Kui Liu
Song-Hua Chen
Bin Chen
author_facet Qian Wu
Yang Liu
Wei Wang
Yu Zhang
Kui Liu
Song-Hua Chen
Bin Chen
author_sort Qian Wu
collection DOAJ
description BackgroundSystemic lupus erythematosus (SLE) patients are particularly susceptible to infections, such as pulmonary tuberculosis (PTB) and extrapulmonary tuberculosis (EPTB). This meta-analysis aimed to determine the incidence and prevalence of tuberculosis (TB) in SLE patients.MethodsThe Web of Science, PubMed, Cochrane Library, and Chinese National Knowledge Infrastructure databases were searched for articles of relevant studies published from the dates the databases were established until April 30, 2022. The I2 statistic and Q test were used to evaluate heterogeneity among the analysed studies. Random-effects models were utilised and subgroup analyses were conducted for analysis of the study data.ResultsA total of 35 studies with 46,327 SLE patients were eligible for analysis. The incidence and prevalence of TB among the SLE patients were 1.16 per 100 person-years (95% confidence interval (CI): 0.69-1.93) and 3.59% (95% CI: 2.57%-5.02%), respectively. The pooled prevalence of SLE-PTB and SLE-EPTB was 2.46% (95% CI: 1.73%-3.51%) and 1.42% (95% CI: 0.98%-2.06%), respectively. Subgroup analyses showed that the incidence of SLE-TB was higher in Africa and in countries with a high TB burden than in countries with a low TB burden. The prevalence of SLE-TB was elevated in Asia, in patients taking a mean daily dose of glucocorticoids ≥20 mg, in studies with small sample sizes (n <1000) and ended before 2001.ConclusionsThe available evidence suggests that both the incidence and prevalence of TB in SLE patients are high. This study provides a more specific understanding of SLE-TB, which can help health policymakers in the development of preventive strategies for reducing the SLE-TB burden.
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spelling doaj.art-8757a399a40d4893b6658df0800bcd812022-12-22T03:04:07ZengFrontiers Media S.A.Frontiers in Immunology1664-32242022-07-011310.3389/fimmu.2022.938406938406Incidence and prevalence of tuberculosis in systemic lupus erythematosus patients: A systematic review and meta-analysisQian Wu0Yang Liu1Wei Wang2Yu Zhang3Kui Liu4Song-Hua Chen5Bin Chen6Department of Tuberculosis Control and Prevention, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, ChinaDepartment of Infectious Diseases Control and Prevention, Jiaxing Center for Disease Control and Prevention, Jiaxing, ChinaDepartment of Tuberculosis Control and Prevention, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, ChinaDepartment of Tuberculosis Control and Prevention, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, ChinaDepartment of Tuberculosis Control and Prevention, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, ChinaDepartment of Tuberculosis Control and Prevention, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, ChinaDepartment of Tuberculosis Control and Prevention, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, ChinaBackgroundSystemic lupus erythematosus (SLE) patients are particularly susceptible to infections, such as pulmonary tuberculosis (PTB) and extrapulmonary tuberculosis (EPTB). This meta-analysis aimed to determine the incidence and prevalence of tuberculosis (TB) in SLE patients.MethodsThe Web of Science, PubMed, Cochrane Library, and Chinese National Knowledge Infrastructure databases were searched for articles of relevant studies published from the dates the databases were established until April 30, 2022. The I2 statistic and Q test were used to evaluate heterogeneity among the analysed studies. Random-effects models were utilised and subgroup analyses were conducted for analysis of the study data.ResultsA total of 35 studies with 46,327 SLE patients were eligible for analysis. The incidence and prevalence of TB among the SLE patients were 1.16 per 100 person-years (95% confidence interval (CI): 0.69-1.93) and 3.59% (95% CI: 2.57%-5.02%), respectively. The pooled prevalence of SLE-PTB and SLE-EPTB was 2.46% (95% CI: 1.73%-3.51%) and 1.42% (95% CI: 0.98%-2.06%), respectively. Subgroup analyses showed that the incidence of SLE-TB was higher in Africa and in countries with a high TB burden than in countries with a low TB burden. The prevalence of SLE-TB was elevated in Asia, in patients taking a mean daily dose of glucocorticoids ≥20 mg, in studies with small sample sizes (n <1000) and ended before 2001.ConclusionsThe available evidence suggests that both the incidence and prevalence of TB in SLE patients are high. This study provides a more specific understanding of SLE-TB, which can help health policymakers in the development of preventive strategies for reducing the SLE-TB burden.https://www.frontiersin.org/articles/10.3389/fimmu.2022.938406/fullsystemic lupus erythematosustuberculosisincidenceprevalenceglucocorticoids
spellingShingle Qian Wu
Yang Liu
Wei Wang
Yu Zhang
Kui Liu
Song-Hua Chen
Bin Chen
Incidence and prevalence of tuberculosis in systemic lupus erythematosus patients: A systematic review and meta-analysis
Frontiers in Immunology
systemic lupus erythematosus
tuberculosis
incidence
prevalence
glucocorticoids
title Incidence and prevalence of tuberculosis in systemic lupus erythematosus patients: A systematic review and meta-analysis
title_full Incidence and prevalence of tuberculosis in systemic lupus erythematosus patients: A systematic review and meta-analysis
title_fullStr Incidence and prevalence of tuberculosis in systemic lupus erythematosus patients: A systematic review and meta-analysis
title_full_unstemmed Incidence and prevalence of tuberculosis in systemic lupus erythematosus patients: A systematic review and meta-analysis
title_short Incidence and prevalence of tuberculosis in systemic lupus erythematosus patients: A systematic review and meta-analysis
title_sort incidence and prevalence of tuberculosis in systemic lupus erythematosus patients a systematic review and meta analysis
topic systemic lupus erythematosus
tuberculosis
incidence
prevalence
glucocorticoids
url https://www.frontiersin.org/articles/10.3389/fimmu.2022.938406/full
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