Patient characteristics (n = 180).

Biologics have revolutionized the treatment of rheumatoid arthritis (RA) in recent years. However, data from clinical trials and actual clinical practice have shown that biologics currently in use may constitute a risk factor for reactivation of tuberculosis (TB) in patients with latent TB infection. Therefore, screening for latent and active TB infection is mandatory before initiating biologic therapy in patients with RA. This prospective study aimed to analyze the clinical characteristics of patients with RA receiving biologic disease-modifying antirheumatic drugs at Bach Mai Hospital, Vietnam, between 2017 and 2022, and to identify factors affecting the occurrence of active and latent TB infection among these patients. Over a 12-month follow-up period, latent TB infection was confirmed in 20% of the total 180 included patients, while 3 (1.7%) patients developed active TB (one case of pulmonary, pleural, and gluteal TB each). History of TB risk factor exposure and lack of education were significantly associated with the occurrence of active and latent TB infection, with odds ratios (95% confidence intervals [CIs]) of 1.98 (1.78; 2.2) and 1.45 (1.31; 1.6), respectively. Follow-up duration and number of X-ray, computed tomography, bronchoscopy, and sputum acid-fast bacteria examinations were identified as factors that can aid in the early diagnosis of latent TB, with odds ratios (95% CIs) of 1.00 (1; 1.01), 1.02 (1; 1.05), 1.12 (1.11; 1.2), 1.11 (1.09; 1.2), and 1.13 (1.09; 1.17), respectively. Our study showed that, in countries with high TB burden like Vietnam, latent TB infection has high prevalence among patients with RA. We also provide useful information for the screening, monitoring, and treatment of latent and active TB infection in patients with RA.近年来，生物制剂彻底革新了类风湿关节炎（RA）的治疗范式。然而，临床试验与真实世界临床实践的数据均证实，当前临床应用的生物制剂可能会使潜伏性结核感染患者出现结核病复燃风险。因此，在为RA患者启动生物制剂治疗前，对其潜伏性与活动性结核感染进行筛查是强制性临床要求。本项前瞻性研究旨在分析2017至2022年间，越南巴克迈医院接受生物制剂改善病情抗风湿药治疗的RA患者的临床特征，并明确该类患者中活动性与潜伏性结核感染发生的影响因素。在为期12个月的随访周期内，纳入研究的180例患者中，20%确诊潜伏性结核感染；另有3例（占比1.7%）进展为活动性结核，其中肺部结核、胸膜结核与臀部结核各1例。结核危险因素暴露史与受教育程度不足，与活动性及潜伏性结核感染的发生显著相关，其比值比（95%置信区间[CIs]）分别为1.98（1.78；2.2）与1.45（1.31；1.6）。随访时长、X线检查次数、计算机断层扫描（CT）次数、支气管镜检查次数以及痰抗酸杆菌检测次数，被确定为有助于潜伏性结核早期诊断的影响因素，其比值比（95%置信区间[CIs]）分别为1.00（1；1.01）、1.02（1；1.05）、1.12（1.11；1.2）、1.11（1.09；1.2）与1.13（1.09；1.17）。本研究显示，在越南这类结核病负担较高的国家中，RA患者的潜伏性结核感染患病率较高。本研究同时为RA患者潜伏性与活动性结核感染的筛查、监测及治疗提供了具有临床价值的参考依据。