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Influenza and tuberculosis co-infection: A systematic review

tetano

Editor, Senior Moderator
Influenza Other Respir Viruses. 2019 Sep 30. doi: 10.1111/irv.12670. [Epub ahead of print] [h=1]Influenza and tuberculosis co-infection: A systematic review.[/h]
Walaza S[SUP]1,[/SUP][SUP]2[/SUP], Cohen C[SUP]1,[/SUP][SUP]2[/SUP], Tempia S[SUP]3,[/SUP][SUP]4[/SUP], Moyes J[SUP]1,[/SUP][SUP]2[/SUP], Nguweneza A[SUP]1[/SUP], Madhi SA[SUP]1,[/SUP][SUP]5,[/SUP][SUP]6[/SUP], McMorrow M[SUP]3,[/SUP][SUP]4,[/SUP][SUP]7[/SUP], Cohen AL[SUP]3,[/SUP][SUP]4,[/SUP][SUP]8[/SUP].
[h=3]Author information[/h] 1 Centre for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases of the National Health Laboratory Service, Johannesburg, South Africa. 2 School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa. 3 Influenza Division, Centers for Disease Control and Prevention, Atlanta, GA, USA. 4 Influenza Program, Centers for Disease Control and Prevention, Pretoria, South Africa. 5 Medical Research Council, Respiratory and Meningeal Pathogens Research Unit, University of the Witwatersrand, Johannesburg, South Africa. 6 Department of Science and Technology/National Research Foundation: Vaccine Preventable Diseases, University of the Witwatersrand, Johannesburg, South Africa. 7 U.S. Public Health Service, Rockville, MD, USA. 8 Global Immunization Monitoring and Surveillance, Expanded Programme on Immunization Department of Immunization, Vaccines and Biologicals World Health Organization, Geneva, Switzerland.

[h=3]Abstract[/h] [h=4]INTRODUCTION:[/h] There are limited data on risk of severe disease or outcomes in patients with influenza and pulmonary tuberculosis (PTB) co-infection compared to those with single infection.
[h=4]METHODS:[/h] We conducted a systematic review of published literature on the interaction of influenza viruses and PTB. Studies were eligible for inclusion if they presented data on prevalence, disease association, presentation or severity of laboratory-confirmed influenza among clinically diagnosed or laboratory-confirmed PTB cases. We searched eight databases from inception until December 2018. Summary characteristics of each study were extracted, and a narrative summary was presented. Cohort or case-control studies were assessed for potential bias using the Newcastle-Ottawa scale.
[h=4]RESULTS:[/h] We assessed 5154 abstracts, reviewed 146 manuscripts and included 19 studies fulfilling selection criteria (13 human and six animal). Of seven studies reporting on the possible effect of the underlying PTB disease in patients with influenza, three of four analytical studies reported no association with disease severity of influenza infection in those with PTB, whilst one study reported PTB as a risk factor for influenza-associated hospitalization. An association between influenza infection and PTB disease was found in three of five analytical studies; whereas the two other studies reported a high frequency of PTB disease progression and complications among patients with seasonal influenza co-infection.
[h=4]CONCLUSION:[/h] Human analytical studies of an association between co-infection and severe influenza- or PTB-associated disease or increased prevalence of influenza co-infection in individuals' hospitalized for PTB were not conclusive. Data are limited from large, high-quality, analytical epidemiological studies with laboratory-confirmed endpoints.
? 2019 The Authors. Influenza and Other Respiratory Viruses Published by John Wiley & Sons Ltd.


[h=4]KEYWORDS:[/h] influenza; interaction; tuberculosis

PMID: 31568678 DOI: 10.1111/irv.12670
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