The prevalence and predictors of latent TB infection (LTBI) of COPD patients in Taiwan

<bold>Background:</bold> Chronic Obstructive Pulmonary Disease (COPD) often coexists with pulmonary Tuberculosis (TB) with 3-folds higher risk, which possibly linked to activation of latent TB infection (LTBI). Our study aims to assess LTBI prevalence and predictors in COPD patients. <bold>Methods:</bold> Patients > 60 years with COPD for > 1 year during Jan. 2021 to April 2023 received LTBI screening were enrolled for analysis. Treatment options were once-weekly isoniazid (INH) and rifapentine (RPT) for 12 weeks (3HP), daily INH and RPT for 28 days (1HP), 4months rifampin (4R) and daily INH for 9 months (9H). The treatment regimen was based on shared decision-making. We used logistic regression analysis for QFT-positivity predictors and also reported the treatment course of LTBI. <bold>Results:</bold> During the study, 443 COPD patients (age: 72.2±7.3 years) underwent IGRA-plus testing; 80.8% were male, 83.7% were smokers, and 15.3% had asthma. Of these, 26.6% were QFT-plus positive. Baseline characteristics were similar between LTBI and non-LTBI groups. Smoking pack-years (aOR 1.027, p<0.001), COPD duration (aOR 1.116, p=0.03), and inhaled corticosteroid use (aOR 2.81, p<0.001) were correlated with QFT-positivity. Among QFT-plus cases, 80% received LTBI treatment, with varying completion rates: 94.5% in 3HP, 85.7% in 1HP, 40% in 3HR, 80% in 4R, and none in 9H. Adverse reactions were the primary cause of treatment discontinuation. <bold>Conclusion:</bold> Prompt LTBI intervention should be considered for COPD patients, particularly those with heavy smoking history, long COPD duration, and use of inhaled corticosteroid. Current applicable LTBI treatment regmines are safe for COPD patients with high completion rate.