Abstract
BackgroundChronic fatigue syndrome (CFS) has been shown to be associated with infections. Tuberculosis (TB) is a highly prevalent infectious disease. Patients with chronic fatigue syndrome and post-tuberculosis experience similar symptoms. Furthermore, chronic fatigue syndrome and tuberculosis share similar plasma immunosignatures. This study aimed to clarify the risk of chronic fatigue syndrome following the diagnosis of Mycobacterium tuberculosis infection (MTI), by analyzing the National Health Insurance Research Database of Taiwan.Methods7666 patients aged 20 years or older with newly diagnosed Mycobacterium tuberculosis infection during 2000–2011 and 30,663 participants without Mycobacterium tuberculosis infection were identified. Both groups were followed up until the diagnoses of chronic fatigue syndrome were made at the end of 2011.ResultsThe relationship between Mycobacterium tuberculosis infection and the subsequent risk of chronic fatigue syndrome was estimated through Cox proportional hazards regression analysis, with the incidence density rates being 3.04 and 3.69 per 1000 person‐years among the non‐Mycobacterium tuberculosis infection and Mycobacterium tuberculosis infection populations, respectively (adjusted hazard ratio [HR] = 1.23, with 95% confidence interval [CI] 1.03–1.47). In the stratified analysis, the Mycobacterium tuberculosis infection group were consistently associated with a higher risk of chronic fatigue syndrome in the male sex (HR = 1.27, 95% CI 1.02–1.58) and age group of ≥ 65 years old (HR = 2.50, 95% CI 1.86–3.38).ConclusionsThe data from this population‐based retrospective cohort study revealed that Mycobacterium tuberculosis infection is associated with an elevated risk of subsequent chronic fatigue syndrome.
Highlights
Chronic fatigue syndrome (CFS) has been shown to be associated with infections
With every third person on the Earth having Mycobacterium tuberculosis infection (MTI), tuberculosis (TB) is a highly prevalent infectious disease that continues to pose a serious challenge to public health
72% of the patients with TB have moderate-to-severe anxiety and depression according to Hospital Anxiety and Depression Scale (HADS) [12], which considers some of the somatic symptoms
Summary
Chronic fatigue syndrome (CFS) has been shown to be associated with infections. Tuberculosis (TB) is a highly prevalent infectious disease. Patients with chronic fatigue syndrome and post-tuberculosis experience similar symptoms. Chronic fatigue syndrome and tuberculosis share similar plasma immunosignatures. This study aimed to clarify the risk of chronic fatigue syndrome following the diagnosis of Mycobacterium tuberculosis infection (MTI), by analyzing the National Health Insurance Research Database of Taiwan. CFS affects physical but mental status with profound disability It was considered a psychiatric disorder due to a lack of a consistent physiological marker or physical finding [2, 3]. Cytokine alterations are correlated with duration of illness, suggesting that CFS immunopathology is “not static” [13] Abnormal cytokine profiles such as increased production of interferon (IFN) γ were observed in patients with CFS [14] and latent MTI [15]. We investigated the association of TB and CFS by using retrospective cohort data from Taiwan National Health Insurance (NHI) Research Database (NHIRD)
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