-
Frontiers in Immunology 2021Latent tuberculosis infection (LTBI) poses a major roadblock in the global effort to eradicate tuberculosis (TB). A deep understanding of the host responses involved in... (Meta-Analysis)
Meta-Analysis
Latent tuberculosis infection (LTBI) poses a major roadblock in the global effort to eradicate tuberculosis (TB). A deep understanding of the host responses involved in establishment and maintenance of TB latency is required to propel the development of sensitive methods to detect and treat LTBI. Given that LTBI individuals are typically asymptomatic, it is challenging to differentiate latently infected from uninfected individuals. A major contributor to this problem is that no clear pattern of host response is linked with LTBI, as molecular correlates of latent infection have been hard to identify. In this study, we have analyzed the global perturbations in host response in LTBI individuals as compared to uninfected individuals and particularly the heterogeneity in such response, across LTBI cohorts. For this, we constructed individualized genome-wide host response networks informed by blood transcriptomes for 136 LTBI cases and have used a sensitive network mining algorithm to identify top-ranked host response subnetworks in each case. Our analysis indicates that despite the high heterogeneity in the gene expression profiles among LTBI samples, clear patterns of perturbation are found in the immune response pathways, leading to grouping LTBI samples into 4 different immune-subtypes. Our results suggest that different subnetworks of molecular perturbations are associated with latent tuberculosis.
Topics: Computational Biology; Databases, Genetic; Disease Susceptibility; Gene Expression Profiling; Gene Expression Regulation; Genetic Predisposition to Disease; Genome-Wide Association Study; Humans; Latent Tuberculosis; Mycobacterium tuberculosis; Transcriptome; Tuberculosis
PubMed: 33897680
DOI: 10.3389/fimmu.2021.595746 -
Zhejiang Da Xue Xue Bao. Yi Xue Ban =... Dec 2022One fourth of the global population has been infected with , and about 5%-10% of the infected individuals with latent tuberculosis infection (LTBI) will convert to...
One fourth of the global population has been infected with , and about 5%-10% of the infected individuals with latent tuberculosis infection (LTBI) will convert to active tuberculosis (ATB). Correct diagnosis and treatment of LTBI are important in ending the tuberculosis epidemic. Current methods for diagnosing LTBI, such as tuberculin skin test (TST) and interferon-γ release assay (IGRA), have limitations. Some novel biomarkers, such as transcriptome derived host genes in peripheral blood cells, will help to distinguish LTBI from ATB. More emphasis should be placed on surveillance in high-risk groups, including patients with HIV infection, those using biological agents, organ transplant recipients and those in close contact with ATB patients. For those with LTBI, treatment should be based on the risk of progression to ATB and the potential benefit. Prophylactic LTBI regimens include isoniazid monotherapy for 6 or 9 months, rifampicin monotherapy for 4 months, weekly rifapentine plus isoniazid for 3 months (3HP regimen) and daily rifampicin plus isoniazid for 3 months (3HR regimen). The success of the one month rifapentine plus isoniazid daily regimen (1HP regimen) suggests the feasibility of an ultra-short treatment strategy although its efficacy needs further assessment. Prophylactic treatment of LTBI in close contact with MDR-TB patients is another challenge, and the regimens include new anti-tuberculosis drugs such as bedaquiline, delamanid, fluoroquinolone and their combinations, which should be carefully evaluated. This article summarizes the current status of diagnosis and treatment of LTBI and its future development direction.
Topics: Humans; Rifampin; Isoniazid; Latent Tuberculosis; HIV Infections; Antitubercular Agents
PubMed: 36915977
DOI: 10.3724/zdxbyxb-2022-0445 -
International Journal of Infectious... Mar 2017Around one third of the world's population may harbour latent tuberculosis infection (LTBI), an asymptomatic immunological state that confers a heightened risk of... (Review)
Review
Around one third of the world's population may harbour latent tuberculosis infection (LTBI), an asymptomatic immunological state that confers a heightened risk of subsequently developing tuberculosis (TB). Effectively treating LTBI will be essential if the End TB Strategy is to be realized. This review evaluates the evidence in relation to the effectiveness of preventive antibiotic therapy to treat LTBI due to both drug-susceptible and drug-resistant bacteria. Current national and international preventive therapy guidelines are summarized, as well as ongoing randomized trials evaluating regimens to prevent drug-resistant TB. Populations that may benefit most from screening and treatment for LTBI include close contacts of patients with TB (particularly children under 5 years of age) and individuals with substantial immunological impairment. The risks and benefits of treatment must be carefully balanced for each individual. Electronic decision support tools offer one way in which clinicians can help patients to make informed decisions. Modelling studies indicate that the expanded use of preventive therapy will be essential to achieving substantial reductions in the global TB burden. However, the widespread scale-up of screening and treatment will require careful consideration of cost-effectiveness, while ensuring the drivers of ongoing disease transmission are also addressed.
Topics: Antitubercular Agents; Cost-Benefit Analysis; Decision Support Techniques; Humans; Immune Tolerance; Latent Tuberculosis; Mass Screening; Practice Guidelines as Topic; Randomized Controlled Trials as Topic; Tuberculosis, Multidrug-Resistant
PubMed: 27872018
DOI: 10.1016/j.ijid.2016.11.006 -
BMC Public Health Mar 2020There is a global commitment to eliminating tuberculosis (TB). It is critical to detect and treat cases of latent TB infection (LTBI), the reservoir of new TB cases. Our... (Review)
Review
BACKGROUND
There is a global commitment to eliminating tuberculosis (TB). It is critical to detect and treat cases of latent TB infection (LTBI), the reservoir of new TB cases. Our study assesses trends in publication of LTBI-related research.
METHODS
We used the keywords ("latent tuberculosis" OR "LTBI" OR "latent TB") to search the Web of Science for LTBI-related articles published 1995-2018, then classified the results into three research areas: laboratory sciences, clinical research, and public health. We calculated the proportions of LTBI-related articles in each area to three areas combined, the average rates of LTBI-related to all scientific and TB-related articles, and the average annual percent changes (AAPC) in rates for all countries and for the top 13 countries individually and combined publishing LTBI research.
RESULTS
The proportion of LTBI-related articles increased over time in all research areas, with the highest AAPC in laboratory (38.2%/yr), followed by public health (22.9%/yr) and clinical (15.1%/yr). South Africa (rate ratio [RR] = 8.28, 95% CI 5.68 to 12.08) and India (RR = 2.53, 95% CI 1.74 to 3.69) had higher RRs of overall TB-related articles to all articles, but did not outperform the average of the top 13 countries in the RRs of LTBI-related articles to TB-related articles. Italy (RR = 1.95, 95% CI 1.45 to 2.63), Canada (RR = 1.73, 95% CI 1.28 to 2.34), and Spain (RR = 1.53, 95% CI 1.13 to 2.07) had higher RRs of LTBI-related articles to TB-related articles.
CONCLUSIONS
High TB burden countries (TB incidence > 100 per 100,000 population) published more overall TB-related research, whereas low TB burden countries showed greater focus on LTBI. Given the potential benefits, high TB burden countries should consider increasing their emphasis on LTBI-related research.
Topics: Biomedical Research; Global Health; Humans; Internationality; Latent Tuberculosis; Publications
PubMed: 32183753
DOI: 10.1186/s12889-020-8419-0 -
The Lancet. Infectious Diseases Oct 2017Since 1989, the USA has been pursuing the goal of tuberculosis elimination. After substantial progress during the past two decades, the rate of tuberculosis cases in the... (Review)
Review
Since 1989, the USA has been pursuing the goal of tuberculosis elimination. After substantial progress during the past two decades, the rate of tuberculosis cases in the USA each year has now levelled off and remains well above the elimination threshold. Both epidemiological data and modelling underline the necessity of addressing latent tuberculosis infection if further progress is to be made in eliminating the disease. In this Personal View we explore next steps towards elimination. Given the estimated prevalence of latent tuberculosis infection, compared with the limited testing and treatment that currently occur, a major new effort is required. This effort should consist of a surveillance system or registry to monitor progress, scale-up of targeted testing for latent tuberculosis infection in at-risk populations, scale-up of short-course treatment regimens, engagement of affected communities and medical providers who serve those communities, and increased public health staffing for implementation and oversight. Such an effort would benefit greatly from the development of new tools, such as tests that better indicate reactivation risk, and even shorter latent tuberculosis infection treatment regimens than currently exist.
Topics: Antitubercular Agents; Humans; Latent Tuberculosis; Time Factors; Tuberculosis; United States
PubMed: 28495525
DOI: 10.1016/S1473-3099(17)30248-7 -
Ugeskrift For Laeger Mar 2020Diagnosing tuberculosis (TB) in children and adolescents pose a diagnostic challenge due to sparse symptoms and clinical signs. Children are at a much higher risk than... (Review)
Review
Diagnosing tuberculosis (TB) in children and adolescents pose a diagnostic challenge due to sparse symptoms and clinical signs. Children are at a much higher risk than adults of progression to severe disease. In this review, the presentation and management of childhood TB is described. TB in children indicates ongoing transmission and is an indicator of failing disease control in the community. Tests suited to predict progression are warranted, and targeting latent infection is essential to achieve TB elimination. We recommend a low threshold for referral of children suspected of active or latent TB.
Topics: Adolescent; Adult; Child; Humans; Latent Tuberculosis; Tuberculosis
PubMed: 32138825
DOI: No ID Found -
Drug Discoveries & Therapeutics May 2022Individuals in close contact with multidrug-resistant tuberculosis (MDR-TB) patients are subject to an elevated risk of infection, and may develop latent MDR-TB... (Review)
Review
Individuals in close contact with multidrug-resistant tuberculosis (MDR-TB) patients are subject to an elevated risk of infection, and may develop latent MDR-TB infection. Numerous studies have described latent tuberculosis infection (LTBI) as a reservoir of new TB disease. The screening and treatment of latent MDR-TB infection are challenging. Hereby, we reviewed the epidemiology, current management and prevention approach of LTBI in MDR-TB close contacts, to provide additional information for future research direction and policy design formulation to reduce the LTBI reservoir.
Topics: Humans; Latent Tuberculosis; Tuberculosis, Multidrug-Resistant
PubMed: 35466125
DOI: 10.5582/ddt.2022.01029 -
Journal of Immunology Research 2015
Topics: BCG Vaccine; Humans; Latent Tuberculosis; Mycobacterium tuberculosis; Tuberculosis
PubMed: 26345333
DOI: 10.1155/2015/857598 -
Clinical Infectious Diseases : An... Nov 2021
Topics: Humans; Latent Tuberculosis; Tuberculin Test; Tuberculosis; United States
PubMed: 32588882
DOI: 10.1093/cid/ciaa850 -
Global Public Health Aug 2022The Centers for Disease Control and Prevention works to eliminate tuberculosis (TB) disease by finding and treating cases of TB disease and expanding latent tuberculosis...
The Centers for Disease Control and Prevention works to eliminate tuberculosis (TB) disease by finding and treating cases of TB disease and expanding latent tuberculosis infection (LTBI) testing and treatment to prevent TB disease. Approximately 70% of reported TB cases in the United States occur among non-U.S.-born persons. We conducted 15 focus groups with U.S. residents born in the six most common countries of birth among non-U.S.-born TB patients: Mexico, the Philippines, India, Vietnam, China and Guatemala. Participants reacted to 39 messages on LTBI and TB disease risk factors, the Bacille Calmette-Guérin (BCG) vaccine, and LTBI testing and treatment. There was low awareness of LTBI, the TB blood test, and how the TB blood test is not affected by prior BCG vaccination. Several participants thought TB disease is contracted by sharing kitchenware. Some felt negatively targeted when presented with information about countries where TB disease is more common than the U.S. Findings highlight the need for communication aimed at increasing LTBI testing and treatment to include messages framed in ways that will be resonant and actionable to populations at risk. Focus groups revealed LTBI misconceptions which highlight areas for targeted education to decrease TB stigma and increase LTBI testing and treatment.
Topics: BCG Vaccine; China; Humans; India; Latent Tuberculosis; Tuberculosis; United States
PubMed: 34228584
DOI: 10.1080/17441692.2021.1947342