The unexpected resurgence of tuberculosis (TB) in developed countries, as far as the possibility of an hypercoagulable state given by the infection “per se” and the use of anti-TB chemotherapy, provided the rationale for evaluating venous thromboembolism (VTE) as a possible complication of TB. Aim of the present study is to evaluate the incidence of deep vein thrombosis (DVT) and pulmonary embolism (PE) in a large national registry of actively treated TB patients in a low incidence country.
The AIPO/SMIRA study is a prospective national monitoring activity on TB treatment results based on a network of 46 TB units nationwide, under the leadership of the Italian Association of Hospital Pneumologists, the World Health Organization, and the Istituto Superiore di Sanità (technical branch of the Italian Ministry of Health). To date, the registry enrolled 6,027 TB patients. An active survey for the appearance of clinically evident DVT and PE was conducted on a subset of 1,237 patients in the period 1998-2002.
Five (0.4%) patients developed proximal DVT within one month after initiation of anti-TB chemotherapy, complicated in 2 (0.2%) cases by PE. Two (0.2%) additional cases of PE without DVT occurred in the first week of treatment. Overall, the prevalence rate of any VTE event was 0.6%, and all cases occurred among new pulmonary TB cases with rifampicin as part of the initial treatment.
TB, as other infectious conditions, is likely to increase the risk of VTE.
This evidence may support the use of appropriate venous thromboprophylaxis in selected cases.
Marco Ambrosetti, None.