Risk factors on multivariate analysis:
(1) malnutrition
(2) fludarabine therapy
(3) corticosteroid therapy
(4) high risk hematologic malignancy (associated with impaired T-cell function)
High risk hematologic malignancy includes:
(1) Hodgkin's disease
(2) adult T-cell leukemia or lymphoma
(3) lymphoproliferative disease treated with fludarabine and/or high dose corticosteroids
(4) hematopoietic stem cell transplant (HSCT; probably related to prophylaxis of graft-vs-host disease)
where:
• One criteria for a high risk group is therapy with fludarabine and/or corticosteroids, which are also listed as risk factors.
• High dose corticosteroid therapy was a cumulative dose >= 14 mg/kg.
• High dose corticosteroid therapy is associated with a high risk hematologic malignancy, but high risk for tuberculosis just specifies corticosteroid therapy.
Additional risk factors to consider (not listed in the paper):
(1) moderate-to-high prevalence of tuberculosis in the community
(2) therapy with infliximab or other immunotherapy targeting lymphocytes (The study was done from 1990 to 2000, and these drugs were probably not widely available in Rio de Janeiro at the time)
