Comparison of three tests for latent tuberculosis infection in high-risk people in the USA: an observational cohort study

Ho, Christine; Feng, Pei-Jean; Stout, Jason E.; Chen, Michael; Katz, Dolly; Flood, Jennifer; Pascopella, Lisa; Higashi, Julie; Moser, Kathleen; Moore, Monica; Garfein, Richard S.; Benson, Constance A.; Belknap, Robert; Reves, Randall; Stout, Jason E.; Ahmed, Amina; Pettit, April C; Blumberg, Henry M.; Oladele, Alawode; Lauzardo, Michael; Séraphin, Marie Nancy; Brostrom, Richard; Khurana, Renuka; Cronin, Wendy A.; Dorman, Susan E.; Narita, Michiko; Horne, David; Miller, Thaddeus L.

doi:10.1016/s1473-3099(21)00145-6

Cited by 27 publications

(32 citation statements)

References 30 publications

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“…The difference in the trend might be explained by the declining sensitivity of TST in older adults reported in previous studies. 57 On the other hand, the lack of the trend for QFT-GIT was affected by a single study in which the test had a lower predictive performance in children than adults. 24 However, given the small number of events and multiple analyses, this observation may be a chance finding.…”

Section: Discussionmentioning

confidence: 99%

Predictive performance of interferon-gamma release assays and the tuberculin skin test for incident tuberculosis: an individual participant data meta-analysis

et al. 2023

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Section: Discussionmentioning

confidence: 99%

Predictive performance of interferon-gamma release assays and the tuberculin skin test for incident tuberculosis: an individual participant data meta-analysis

et al. 2023

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“…The risk of developing active TB after being infected with MTB is determined by various factors, including age, virulence of the organism, immune status, and magnitude of initial infection [ 11 ]. Generally, younger children, particularly those <5 years of age, are at greater risk of developing active TB [ 11 , 12 ]. However, in the current cohort of patients, children aged <5 years made up only 23.8% of the registered childhood TB patients.…”

Section: Discussionmentioning

confidence: 99%

Treatment Outcomes of Childhood TB Patients in Four TB High Burden States of Malaysia: Results from a Multicenter Retrospective Cohort Study

et al. 2022

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Data regarding treatment outcomes among childhood TB patients are lacking in Malaysia. The present study aimed to evaluate the treatment outcomes and predictors of unsuccessful treatment outcomes among childhood TB patients in four TB high-burden states of Malaysia. This was a retrospective cohort study conducted at 13 healthcare centers in four states of Malaysia, namely, Sabah, Sarawak, Selangor, and Penang. During the study period, a total of 8932 TB patients were enrolled for treatment at the study sites, of whom 206 (2.31%) were children. The majority of the childhood TB patients were female (52.9%) and belonged to the age group of 6–10 years (42.7%). Pulmonary TB accounted for 70.9% of childhood TB. Among childhood PTB patients, 50% were sputum smear negative. One hundred and seventy-eight patients (86.4%) were successfully treated (87 were cured and 91 completed treatment). Among 28 (13.6%) patients with unsuccessful treatment outcomes, 13 (6.3%) died, 3 (1.5%) failed treatment, 9 (4.4%) defaulted, and 3 (1.5%) were transferred out. Multivariate analysis revealed that patients’ age (5–14 years) (OR = 0.279, p-value = 0.006) and male gender (OR = 0.390, p-value = 0.046) had a statistically significant negative association with unsuccessful treatment outcomes. The prevalence of childhood TB in the current study was comparable to the recently published national estimates. The study sites reached the WHO target of treatment success. Special attention to patients with identified risk factors can improve treatment outcomes.

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“…Our plan is, therefore, to carry out a prospective study to explore whether measuring both anti-MABSC IgG and the production of MABSC-lysate-induced IFN-γ (and possibly also TNF-α and IL-2) by blood cells will be useful for early diagnosis of NTM infections. We will especially focus on patients with possible latent or subclinical infection ( Ho et al., 2021 ), and correlate our immunological tests with the monthly respiratory mycobacterial cultures we have been doing since 2012, lung function tests and chest high-resolution computed tomography. This may provide a better differentiation between colonisation, latent, subclinical, and clinically active infection, and also guide more invasive approaches, such as bronchoalveolar lavage, in order to accurately detect a specific NTM pathogen.…”

Section: Discussionmentioning

confidence: 99%

Adaptive Immune Response to Mycobacterium abscessus Complex (MABSC) in Cystic Fibrosis and the Implications of Cross-Reactivity

Mauch

Jensen

Qvist

et al. 2022

Front. Cell. Infect. Microbiol.

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BackgroundWe aimed to characterise the adaptive immune response to Mycobacterium abscessus complex (MABSC) and its cross-reactivity with Mycobacterium avium complex (MAC) and Mycobacterium bovis (Bacille Calmette-Guérin, BCG) in cystic fibrosis (CF) patients and non-CF controls in terms of lymphocyte proliferation and immunophenotyping, cytokine production and anti-MABSC IgG plasma levels.MethodsIn this cross-sectional analysis, peripheral blood mononuclear cells (PBMC) from CF patients with MABSC (CF/MABSC, n=12), MAC infection history (CF/MAC, n=5), no NTM history (CF/NTM-, n=15), BCG-vaccinated (C/BCG+, n=9) and non-vaccinated controls (C/BCG-, n=8) were cultured for four days under stimulation with an in-house MABSC lysate and we used flow cytometry to assess lymphocyte proliferation (given by lymphoblast formation) and immunophenotypes. Cytokine production was assessed after overnight whole blood stimulation with the same lysate, and anti-MABSC IgG levels were measured in plasma from non-stimulated blood.ResultsAll CF/MABSC patients had increased CD3+ and CD19+ lymphoblast formation upon PBMC stimulation with MABSC lysate. There was a higher rate of CD3+ than CD19+ lymphoblasts, predominance of CD4+ over CD8+ lymphoblasts, IFN-γ, TNF-α and IL-2 production, low production of the Th17-associated IL-17, and discrete or no production of Th2/B cell-associated cytokines soluble CD40 ligand (CD40L), IL-4 and IL-5, indicating a Th1-dominated phenotype and infection restricted to the lungs. A similar pattern was seen in C/BCG+ controls, and CF/MAC patients, pointing to cross-reactivity. MABSC-IgG levels were higher in CF/MABSC patients than in both control groups, but not CF/NTM- patients, most of whom also had CD3+ and/or CD19+ lymphoblast formation upon PBMC stimulation, indicating previous exposure, subclinical or latent infection with MABSC or other NTM.ConclusionThe anti-MABSC immune response is Th1-skewed and underlines the cross-reactivity in the anti-mycobacterial immune response. The results, together with published clinical observations, indicate that BCG vaccination may cross-react against NTM in CF patients, and this should be investigated. Due to cross-reactivity, it would also be interesting to investigate whether a combination of MABSC-induced cytokine production by blood cells and anti-MABSC IgG measurement can be useful for identifying latent or subclinical infection both with MABSC and other NTM in CF patients.

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Comparison of three tests for latent tuberculosis infection in high-risk people in the USA: an observational cohort study

Cited by 27 publications

References 30 publications

Predictive performance of interferon-gamma release assays and the tuberculin skin test for incident tuberculosis: an individual participant data meta-analysis

Predictive performance of interferon-gamma release assays and the tuberculin skin test for incident tuberculosis: an individual participant data meta-analysis

Treatment Outcomes of Childhood TB Patients in Four TB High Burden States of Malaysia: Results from a Multicenter Retrospective Cohort Study

Adaptive Immune Response to Mycobacterium abscessus Complex (MABSC) in Cystic Fibrosis and the Implications of Cross-Reactivity

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