Impact of Allergic Disease on the Risk of Mycobacterial Disease

Abstract

Background: The association between allergic diseases and the risk of mycobacterial disease is unclear. Objective: To evaluate the association between allergic diseases and mycobacterial diseases. Methods: This was a population-based cohort study of 3,838,680 individuals, without prior mycobacterial disease, who participated in the 2009 National Health Screening Exam. We evaluated the prevalence of mycobacterial disease (tuberculosis or nontuberculous mycobacterial infection) in participants with allergic disease (asthma, allergic rhinitis, or atopic dermatitis) and those without allergic disease. We followed the cohort up until the date of mycobacterial disease diagnosis, follow-up loss, death, or December 2018. Results: During a median follow-up of 8.3 (interquartile range, 8.1-8.6) years, 0.6% of participants developed mycobacterial disease. The prevalence of mycobacterial disease was significantly higher in those with allergic diseases than in those without allergic diseases (1.0 vs 0.7/1000 person-years; P < .001), with an adjusted hazard ratio of 1.13 (95% CI, 1.10-1.17). Asthma (adjusted hazard ratio, 1.37; 95% CI, 1.29-1.45) and allergic rhinitis (adjusted hazard ratio, 1.07; 95% CI, 1.04-1.11) increased the hazard of mycobacterial disease, whereas atopic dermatitis did not. The association between allergic diseases and hazard of mycobacterial disease was more prominent in older (age ≥ 65 years, P for interaction = .012) and obese (body mass index ≥ 25 kg/m2, P for interaction < .001) participants. Conclusion: Allergic diseases including asthma and allergic rhinitis were associated with an increased risk of mycobacterial disease, whereas atopic dermatitis was not.