Níveis de vitamina D associados à tuberculose na população privada de liberdade do Estado de Mato Grosso do Sul, Brasil

Abstract

Insufficient vitamin D levels have been associated with tuberculosis (TB), but data are conflicting as to whether it is a cause or consequence of disease. We conducted a case -control study and two nested case-control studies to determine whether vitamin D levels were associated with active TB, risk of Mycobacterium tuberculosis infection and progression to the active TB in prisoners in Brazil. Each prisoner was compared with two controls matched on the basis of age, cell block and incarceration time. In multivariable conditional logistic regression, insufficient vitamin D levels (OR, 3.77; 95% CI, 1.04 -13.64) were more likely in prisoners with active TB. In contrast, vitamin D levels were not found to be a risk factor for either TST conversion (OR, 2.49; 95% CI, 0.64-9.66) or progression to active disease (OR, 0.59; 95% CI, 0.13-2.62). Factors associated with TST conversion risk were black race (OR, 11.52; 95% CI, 2.01-63.36), less than 4 years of schooling (OR, 2.70; 95% CI, 0.90-8.16), cigarette smoking (OR, 0.23; 95% CI, 0.06-0.79). Risk of progression to active TB was only found to be associated with cigarette smoking (OR, 7.42; 95% CI, 1.23 -44.70). Our findings in the prison population show that insufficient vitamin D levels are more common in individuals with active TB, but are not a risk factor acquisition of latent TB or progression to active TB.