Background: Although there are theoretical reasons for believing that asthma and atopy may be negatively\ncorrelated with tuberculosis, epidemiological studies have had conflicting findings.\nObjective: To determine if people with confirmed tuberculosis were less likely to be atopic and less likely to have\natopic disease including asthma compared to those with no previous tuberculosis.\nMethods: Patients in Lima, Peru with a prior history of tuberculosis were identified from clinic records in this cohort\nstudy. A representative sample of individuals without a prior tuberculosis diagnosis was recruited from the same\ncommunity. Allergen skin prick testing was performed to classify atopic status. Allergic rhinitis was identified by\nhistory. Asthma was defined by symptoms and spirometry. Eosinophilic airway inflammation was measured using\nexhaled nitric oxide levels.\nResults: We evaluated 177 patients with, and 161 individuals without, previous tuberculosis. There was a lower\nprevalence of atopy among people with prior tuberculosis on univariate analysis (odds ratio 0.57; 95% confidence\ninterval 0.37-0.88) but, after adjustment for potential confounders, this was no longer statistically significant\n(aOR 0.64, 95% CI 0.41-1.01). The prevalence of allergic rhinitis (aOR 0.76, 95% CI 0.47 to 1.24 and asthma\n(aOR 1.18, 95% CI 0.69 to 2.00) did not differ significantly between the two groups. We also found no significant\ndifference in the prevalence of elevated exhaled nitric oxide (aOR 1.30, 95% CI 0.78 to 2.17) or a combined index of\natopic disease (aOR 0.86, 95% CI 0.54 to 1.36).\nConclusion: In this urban environment in a middle-income country, prior tuberculosis may be associated with a\nreduced risk of atopy but does not protect against asthma and atopic disease.
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