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BMC Infectious Diseases
Published in: BMC Infectious Diseases 1/2011

Open Access 01-12-2011 | Research article

Latent tuberculosis infection, tuberculin skin test and vitamin D status in contacts of tuberculosis patients: a cross-sectional and case-control study

Authors: Alberto Arnedo-Pena, José Vicente Juan-Cerdán, Angeles Romeu-Garcia, Daniel Garcia-Ferrer, Rita Holguín-Gómez, Jesús Iborra-Millet, Concepción Herrero-Carot, María Jesús Sanchis Piñana, Juan Bellido-Blasco, José Antonio Ferrero-Vega, Lourdes Safont Adsuara, Esther Silvestre Silvestre, Noemi Meseguer Ferrer, Vicenta Rodrigo Bartual

Published in: BMC Infectious Diseases | Issue 1/2011

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Abstract

Background

Deficient serum vitamin D levels have been associated with incidence of tuberculosis (TB), and latent tuberculosis infection (LTBI). However, to our knowledge, no studies on vitamin D status and tuberculin skin test (TST) conversion have been published to date. The aim of this study was to estimate the associations of serum 25-hydroxyvitamin D3 (25[OH]D) status with LTBI prevalence and TST conversion in contacts of active TB in Castellon (Spain).

Methods

The study was designed in two phases: cross-sectional and case-control. From November 2009 to October 2010, contacts of 42 TB patients (36 pulmonary, and 6 extra-pulmonary) were studied in order to screen for TB. LTBI and TST conversion cases were defined following TST, clinical, analytic and radiographic examinations. Serum 25(OH)D levels were measured by electrochemiluminescence immunoassay (ECLIA) on a COBAS® 410 ROCHE® analyzer. Logistic regression models were used in the statistical analysis.

Results

The study comprised 202 people with a participation rate of 60.1%. Only 20.3% of the participants had a sufficient serum 25(OH)D (≥ 30 ng/ml) level. In the cross-sectional phase, 50 participants had LTBI and no association between LTBI status and serum 25(OH)D was found. After 2 months, 11 out of 93 negative LTBI participants, without primary prophylaxis, presented TST conversion with initial serum 25(OH)D levels: a:19.4% (7/36): < 20 ng/ml, b:12.5% (4/32):20-29 ng/ml, and c:0%(0/25) ≥ 30 ng/ml. A sufficient serum 25(OH)D level was a protector against TST conversion a: Odds Ratio (OR) = 1.00; b: OR = 0.49 (95% confidence interval (CI) 0.07-2.66); and c: OR = 0.10 (95% CI 0.00-0.76), trends p = 0.019, adjusted for high exposure and sputum acid-fast bacilli positive index cases. The mean of serum level 25(OH)D in TST conversion cases was lower than controls,17.5 ± 5.6 ng/ml versus 25.9 ± 13.7 ng/ml (p = 0.041).

Conclusions

The results suggest that sufficient serum 25(OH)D levels protect against TST conversion.
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Metadata
Title
Latent tuberculosis infection, tuberculin skin test and vitamin D status in contacts of tuberculosis patients: a cross-sectional and case-control study
Authors
Alberto Arnedo-Pena
José Vicente Juan-Cerdán
Angeles Romeu-Garcia
Daniel Garcia-Ferrer
Rita Holguín-Gómez
Jesús Iborra-Millet
Concepción Herrero-Carot
María Jesús Sanchis Piñana
Juan Bellido-Blasco
José Antonio Ferrero-Vega
Lourdes Safont Adsuara
Esther Silvestre Silvestre
Noemi Meseguer Ferrer
Vicenta Rodrigo Bartual
Publication date
01-12-2011
Publisher
BioMed Central
Published in
BMC Infectious Diseases / Issue 1/2011
Electronic ISSN: 1471-2334
DOI
https://doi.org/10.1186/1471-2334-11-349

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