Latent TB and depressive symptoms in household contacts of persons with active TB

Abstract

BACKGROUND: Depression is common among persons with TB and is associated with poor clinical outcomes. However, little is known about the relationship between latent TB infection (LTBI) and depression. We assessed the association between LTBI and depressive symptoms among household contacts (HHCs) of patients receiving TB treatment.METHODS: We enrolled 1,009 HHCs of 307 patients receiving TB treatment in Lima, Peru, during 2016–2018. At enrollment, HHC LTBI status was assessed using the interferon-gamma release assay (IGRA). Depressive symptoms were assessed at baseline and 12 months later using the Patient Health Questionnaire-9 (PHQ-9) with a cut-off of <inline-formula id="IE1"><mml:math display="inline"><mml:mo>≥</mml:mo></mml:math></inline-formula>5. We used logistic regression to estimate the odds ratio (OR) for PHQ-9 <inline-formula id="IE2"><mml:math display="inline"><mml:mo>≥</mml:mo></mml:math></inline-formula>5, comparing HHCs with and without baseline LTBI.RESULTS: Among 921 HHCs, 374 (41.0%) had LTBI at baseline, and 69 (12.4%) of 567 HHCs had PHQ-9 <inline-formula id="IE3"><mml:math display="inline" id="im1"><mml:mo>≥</mml:mo></mml:math></inline-formula>5. Compared to HHCs without LTBI at enrollment, those with LTBI had almost two times the odds of PHQ-9 <inline-formula id="IE4"><mml:math display="inline" id="im2"><mml:mo>≥</mml:mo></mml:math></inline-formula>5 at follow-up after controlling for potential confounders (adjusted OR 1.93, 95% CI 1.09–3.39); this association was driven by greater severities of depressive symptoms.CONCLUSION: HHCs with LTBI had increased odds of depressive symptoms 1 year later. This population may benefit from mental health screening and interventions integrated into TB programs.