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Mycobacterium Tuberculosis Infection Incidence in Hospitalized Renal Transplant Patients in the United States, 1998–2000
Article first published online: 29 JUN 2004
American Journal of Transplantation
Volume 4, Issue 9, pages 1523–1528, September 2004
How to Cite
Klote, M. M., Agodoa, L. Y. and Abbott, K. (2004), Mycobacterium Tuberculosis Infection Incidence in Hospitalized Renal Transplant Patients in the United States, 1998–2000. American Journal of Transplantation, 4: 1523–1528. doi: 10.1111/j.1600-6143.2004.00545.x
- Issue published online: 12 AUG 2004
- Article first published online: 29 JUN 2004
- Received 23 March 2004, revised and accepted for publication 6 May 2004
- infection incidence;
- Mycobacterium tuberculosis;
- renal transplant;
- systemic lupus erythematosus
The incidence, risk factors, and prognosis for Mycobacterium tuberculosis (MTB) infection have not been reported in a national population of renal transplant recipients. We performed a retrospective cohort study of 15 870 Medicare patients who received renal transplants from January 1 1998 to July 31 2000. Cox regression analysis derived adjusted hazard ratios (AHR) for factors associated with a diagnosis of MTB infection (by Medicare Institutional Claims) and the association of MTB infection with survival. There were 66 renal transplant recipients diagnosed with tuberculosis infection after transplant (2.5 cases per 1000 person years at risk, with some falling off of cases over time). The most common diagnosis was pulmonary TB (41 cases). In Cox regression analysis, only systemic lupus erythematosus (SLE) was independently associated with TB. Mortality after TB was diagnosed was 23% at 1 year, which was significantly higher than in renal transplant recipients without TB (AHR, 4.13, 95% CI, 2.21, 7.71, p < 0.001). Although uncommon, MTB infection is associated with a substantially increased risk of mortality after renal transplantation. High-risk groups, particularly those with SLE prior to transplant, might benefit from intensified screening.