Dose-response association between salivary cotinine levels and Mycobacterium tuberculosis infection

作者：Shin S S; Laniado Laborin R; Moreno P G; Novotny T E; Strathdee S A; Garfein R S^*

来源：International Journal of Tuberculosis and Lung Disease, 2013, 17(11): 1452-1458.

DOI：10.5588/ijtld.13.0311

• tuberculosis
• tobacco
• substance abuse
• mycobacterial infections
• smoking
• interferon-gamma release assay

SETTING: Tijuana, Mexico. OBJECTIVE: To describe the association between salivary cotinine levels and interferon-gamma (IFN-gamma) release assay results. %26lt;br%26gt;DESIGN: We conducted a cross-sectional study among injection drug users. Salivary cotinine levels were measured using NicAlert, a semi-quantitative dipstick assay. QuantiFERON (R)-TB Gold In-Tube (QFT-GIT) was used to determine Mycobacterium tuberculosis infection. %26lt;br%26gt;RESULTS: Among 234 participants, the prevalence of QFT-GIT positivity for NicAlert cotinine categories 0 (non-smoking), 1 (second-hand smoke exposure or low-level smoking) and 2-6 (regular smoking) were respectively 42.1%, 46.4% and 65.2% (P-trend = 0.012). We found increasing trends in QFT-GIT positivity (P-trend = 0.003) and IFN-gamma concentrations (Spearman%26apos;s r = 0.200, P = 0.002) across cotinine levels 0 to 6. In multivariable log-binomial regression models adjusted for education, cotinine levels were not associated with QFT-GIT positivity when included as smoking categories (1 and 2-6 vs. 0), but were independently associated with QFT-GIT positivity when included as an ordinal variable (prevalence ratio = 1.09 per +1 cotinine level, 95%CI = 1.02-1.46). %26lt;br%26gt;CONCLUSION: Our findings suggest that a dose-response relationship exists between tobacco smoke exposure and M. tuberculosis infection. Longitudinal studies that use biochemical measures for smoking status are needed to confirm our findings.

• 出版日期2013-11