Heavy alcohol consumption increases the risk of active tuberculosis in Taiwanese adults: a nation-wide population-based cohort study

Aims: To investigate the impact of alcohol exposure on tuberculosis (TB) development in Taiwanese adults. Design: Participants from the Taiwan National Health Interview Survey. Alcohol consumption and other covariates were collected by in-person interviews at baseline. Incident cases of active TB were identified from the National Health Insurance database. A multivariable Cox regression model was used to estimate the association between alcohol consumption and active TB, with adjustment for age, sex, smoking, socio-economic status and other covariates. Setting: Taiwan National Health Interview Survey. Participants: A total of 46 196 adult participants aged ≥ 18 years from three rounds (2001, 2005, 2009) of the Taiwan National Health Interview Survey. Measurements: Alcohol consumption was classified into never, social, regular or heavy alcohol use. Heavy alcohol consumption was defined as intoxication at least once/week. Findings: Of the 46 196 study subjects, 61.8, 24.2, 13.5 and 0.5% were classified as never, social, regular and heavy alcohol users, respectively. During the 398 443 person-years of follow-up, 279 (0.60%) subjects developed new-onset active TB. After adjusting for the subject demographics and comorbidities, heavy [hazard ratio (HR) = 5.27; 95% confidence interval (CI) = 2.51–11.09] and regular alcohol users (HR = 1.80; 95% CI = 1.32–2.45) had increased risks of incident TB compared to never users. Moreover, a positive trend between increasing levels of alcohol consumption and the risk of active TB was noted (P < 0.001). Conclusions: In Taiwan, heavy and regular alcohol consumption are associated with higher risks of active tuberculosis.