Background/Aim: Our research hypothesis is that long-term acid suppression can lead to higher
susceptibility to Mycobacterium tuberculosis infection due to defective gastric acid barrier. Our
study aim was to determine the prevalence of long-term acid suppressive therapy use among
patients with Mtb infection and to explore its contribution to the development of infection.
Patients and Methods: A case-control study included 264 patients with newly diagnosed, pulmonary
or extrapulmonary TB, consecutively, and an equal number of normal subjects as a control group.
For all the enrolled, clinical evaluation (medical history and physical examination), abdominal
ultrasonography, chest radiography, and laboratory evaluation were provided. Long-term use of
acid suppressive therapy was defined as the use for three months or more, during the year preceding
the diagnosis of TB.
Results: The study groups were matching regarding age and gender. The most frequent type was
pulmonary TB (65.2%). Omeprazole was the most frequently used acid suppressive agent (39.6%).
Factors associated with Mtb infection were diabetes mellitus, chronic obstructive pulmonary disease,
long-term corticosteroids use, long-term acid suppressive therapy, liver cirrhosis, renal failure, and
congestive heart failure. After adjusting for the cofounding variables, long-term acid suppressive
therapy had adjusted or of 2.1 (95% CI 1.4-6.1; p 0.024) for its use among the study cases.
Conclusions: In conclusion, the wide use of acid suppressive therapy for long durations (especially
PPI) can make the patients more vulnerable to infection with Mtb.