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

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. ### Competing Interest Statement The authors have declared no competing interest. ### Funding Statement This project is entirely supported by the National Institute of Allergy and Infectious Diseases of the U.S. National Institutes of Health under award number 5U19AI111224-07 (PI Murray, M.). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. ### Author Declarations I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained. Yes The details of the IRB/oversight body that provided approval or exemption for the research described are given below: The research ethics committee of the National Institute of Health of Peru (protocol OEE-004-16) and Harvard Medical School (protocol #IRB16-1173) gave ethical approval for this work. I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals. Yes I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance). Yes I have followed all appropriate research reporting guidelines and uploaded the relevant EQUATOR Network research reporting checklist(s) and other pertinent material as supplementary files, if applicable. Yes All data produced in the present work are contained in the manuscript