The Effect of HIV-Related Immunosuppression on the Risk of Tuberculosis Transmission to Household Contacts

Huang, Chuan-Chin; Tchetgen, Eric Tchetgen; Becerra, Mercedes C.; Cohen, Ted; Hughes, Katherine C.; Zhang, Zibiao; Calderón, Róger; Yataco, Rosa; Contreras, Carmen; Galea, Jerome T; Lecca, Leonid; Murray, Megan

doi:10.1093/cid/cit948

Cited by 54 publications

(57 citation statements)

References 18 publications

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“…In addition, the contacts of HIV-infected index cases with sputum smear-positive or apparent cavitary TB disease were as likely to have latent TB infection as the contacts of non-HIVinfected index cases. These findings highlight the interaction between contagion and the presentation of TB disease in HIV-infected persons, who are less likely to have a prolonged illness, lung cavities, or be smear positive and therefore are considered to be less infectious (9). Of note, all index cases recruited to the study were culture positive, partially explaining the unusually high smear-positivity rates and classic radiological findings observed within the cohort, which are uncommon in HIV/TB coinfection (10).…”

mentioning

confidence: 87%

“…The early reasoning was simple: if normal tidal volumes do not normalize Pa CO 2 , larger tidal volumes (12-15 ml/kg) must be better (5); if calories are necessary, hypercaloric diets up to 5,000 kcal must be even better (6); if 100 mg of hydrocortisone per day can attenuate the inflammatory response, 2,000 mg should eliminate it completely (7); and so on. On the contrary, patients with ARDS taught us over the years that treating the lungs gently and providing them with some rest is a better way to buy time for healing (8,9); that giving fewer…”

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confidence: 99%

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Contact Investigation: A Priority for Tuberculosis Control Programs

Saunders¹,

Datta²

2016

Am J Respir Crit Care Med

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confidence: 87%

mentioning

confidence: 99%

Contact Investigation: A Priority for Tuberculosis Control Programs

Saunders¹,

Datta²

2016

Am J Respir Crit Care Med

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“…This is despite individuals having in fact a very high mycobacterial burden (Elliott et al 1993;Crump et al 2012;Huang et al 2014). Indeed, sputum cultures are generally positive as frequently in HIV-infected as -uninfected subjects.…”

Section: Postprimary Pulmonary Tbmentioning

confidence: 99%

Clinical Aspects of Adult Tuberculosis

Loddenkemper

Lipman

Zumla

2015

Cold Spring Harb Perspect Med

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Tuberculosis (TB) in adults can present in a large number of ways. The lung is the predominant site of TB. Primary pulmonary TB should be distinguished from postprimary pulmonary TB, which is the most frequent TB manifestation in adults (70%-80% cases). Cough is common, although the chest radiograph often raises suspicion of disease. Sputum sampling is a key step in the diagnosis of TB, and invasive procedures such as bronchoscopy may be necessary to achieve adequate samples for diagnosis. Extrapulmonary involvement, which may present many years after exposure, occurs in a variable proportion of cases (20%-45%). This reflects the country of origin of patients and also the frequency of associated human immunodeficiency virus (HIV) coinfection. In the latter case, the presentation of TB is often nonspecific, and care needs to be taken to not miss the diagnosis. Anti-TB therapy should be given in line with proven (or assumed) drug resistance. In extrapulmonary TB, adjunctive therapeutic measures may be indicated; although in all cases, support is often required to ensure that people are able to complete treatment with minimal adverse events and maximal adherence to the prescribed regimen, and so reduce risk of future disease for themselves and others.

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“…Source cases are more infectious if they are sputum smear-positive compared to sputum smear-negative,24,25 and although HIV-infected TB cases are considered poor producers of sputum, the evidence that they are less infectious is mixed 26–29. The bacterial load in the sputum influences infectivity.…”

Section: Tuberculosis Infectionmentioning

confidence: 99%

Epidemiology and disease burden of tuberculosis in children: a global perspective

Seddon

Shingadia

2014

IDR

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Our understanding of the tuberculosis (TB) epidemic in children is incomplete due to challenges in diagnosis and reporting. Children have also been largely excluded from research and advocacy. However, the tide appears to be turning and interest in pediatric TB is increasing. In this article, we explore the epidemiology of childhood TB by first reviewing the natural history of TB in children and the factors that impact on each of the stages from exposure to disease. We then discuss how these factors affect what we see at a country and regional level. Finally, we assess the burden of childhood TB globally.

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The Effect of HIV-Related Immunosuppression on the Risk of Tuberculosis Transmission to Household Contacts

Abstract: We found a reduced risk of tuberculosis infection among the household contacts of patients with active tuberculosis who had advanced HIV-related immunosuppression, suggesting reduced transmission from these index patients.

Cited by 54 publications

References 18 publications

Contact Investigation: A Priority for Tuberculosis Control Programs

Contact Investigation: A Priority for Tuberculosis Control Programs

Clinical Aspects of Adult Tuberculosis

Epidemiology and disease burden of tuberculosis in children: a global perspective

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