Latent tuberculosis and depressive symptoms in household contacts of persons with active TB: A cohort study

ABSTRACT Background Depression is common among persons with TB and associated with poor clinical outcomes. However, little is known about the relationship between latent TB infection (LTBI) and depression. Here, we assessed the association between LTBI and depressive symptoms among household contacts (HHCs) of patients receiving TB treatment. Methods We enrolled 1,009 HHCs of 307 patients receiving TB treatment in Lima, Peru, 2016-2018. We assessed HHC LTBI status at enrollment using interferon gamma release assay (IGRA). Depressive symptoms were assessed at baseline and 12 months later using the Patient Health Questionnaire-9 (PHQ-9) using a cutoff of ≥5. We used logistic regression to estimate the odds ratio for PHQ-9 ≥5 comparing HHCs with and without baseline LTBI. Results Among 921 HHCs, 378 (41.0%) had LTBI at baseline, and 70 (12.4%) of 563 HHCs had PHQ-9 ≥5. Compared to HHCs without LTBI at enrollment, those with LTBI had almost two times the odds of PHQ-9 ≥5 at follow-up after controlling for potential confounders (adjusted OR, 1.93, 95% CI, 1.09-3.39); this association was driven by greater severities of depressive symptoms. Conclusion HHCs with LTBI had increased odds of depressive symptoms one year later. This at-risk population may benefit from mental health screening and interventions integrated within TB programs.