Saturday, August 16, 2008

Too much Alcohol may Increase Tuberculosis Risk

Past studies have shown that drinking alcohol can improve longevity. Again, all things are best in moderation. According to a new study, excessive alcohol intake may increase the risk of active tuberculosis. The results follow a systematic review reported in the August 12 issue of BMC Public Health.

The cutoff level for defining an alcohol disorder was set at 40g per day. The investigators of the report found 3 cohort and 18 case-controlled studies, which they sub-categorized according to definition of exposure, and type of tuberculosis studied, also taking into account a variety of confounding information. The results yielded a 3.50 relative risk for tuberculosis in association with excessive alcohol consumption.

The authors write, "The risk of active tuberculosis is substantially elevated in people who drink more than 40 g alcohol per day, and/or have an alcohol use disorder. This may be due to both increased risk of infection related to specific social mixing patterns associated with alcohol use, as well as influence on the immune system of alcohol itself and of alcohol related conditions....These findings have implications for TB control strategies globally, particularly in countries where a high proportion of TB can be attributed to alcohol use."

The study is not without limitations, and may include bias regarding study results, underestimation of alcohol intake, misclassification of exposure, as well as bias in choosing control and study participants.

The authors suggest there may be benefit in further understanding “causal pathways with regards to risk of infection and risk of break down from infection to disease."

Certainly, the take home message for all of us is to moderate our activities and do our best to keep immunity intact through diet, exercise and – of course – by practicing good hand washing. It is also noteworthy that tuberculosis has been in the news a lot - the most recent news involving cases in California. Oh yes - and remain alert to alcohol related social mixing. Though that sounds tongue-in-cheek, it does have validity, especially for travelers.

BMC Public Health. Published online August 12, 2008. 2008;8:289. ◦