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Pulmonology 2018Tuberculosis (TB) is a major cause of childhood morbidity and mortality worldwide. The aim of this review is to describe the management of the child with TB and latent... (Review)
Review
Tuberculosis (TB) is a major cause of childhood morbidity and mortality worldwide. The aim of this review is to describe the management of the child with TB and latent tuberculosis infection (LTBI). To develop this article, a working group reviewed relevant epidemiological and other scientific studies and established practices in conducting LBTI and TB in children. The article describes how to manage the child with LTBI, considering transmission and infectiousness of tuberculosis, contact screening and prioritization of contacts and recommendations on treatment of children with LTBI and how to manage the child with TB considering the susceptibility of children to developing tuberculosis, epidemiology and classification of tuberculosis in children, diagnosis and treatment.
Topics: Child; Humans; Latent Tuberculosis; Tuberculosis
PubMed: 29502937
DOI: 10.1016/j.rppnen.2017.10.007 -
The Journal of Clinical Investigation Feb 2021Humans have been infected with Mycobacterium tuberculosis (Mtb) for thousands of years. While tuberculosis (TB), one of the deadliest infectious diseases, is caused by... (Review)
Review
Humans have been infected with Mycobacterium tuberculosis (Mtb) for thousands of years. While tuberculosis (TB), one of the deadliest infectious diseases, is caused by uncontrolled Mtb infection, over 90% of presumed infected individuals remain asymptomatic and contain Mtb in a latent TB infection (LTBI) without ever developing disease, and some may clear the infection. A small number of heavily Mtb-exposed individuals appear to resist developing traditional LTBI. Because Mtb has mechanisms for intracellular survival and immune evasion, successful control involves all of the arms of the immune system. Here, we focus on immune responses to Mtb in humans and nonhuman primates and discuss new concepts and outline major knowledge gaps in our understanding of LTBI, ranging from the earliest events of exposure and infection to success or failure of Mtb control.
Topics: Animals; Humans; Immune Evasion; Latent Tuberculosis; Mycobacterium tuberculosis
PubMed: 33529162
DOI: 10.1172/JCI136222 -
The New England Journal of Medicine Mar 2022
Topics: Humans; Latent Tuberculosis
PubMed: 35353974
DOI: 10.1056/NEJMc2200195 -
Revista Espanola de Quimioterapia :... Oct 2022Tuberculosis continues to be a major public health problem. A priority objective is the implementation of early diagnosis, contact investigation and latent tuberculosis... (Review)
Review
Tuberculosis continues to be a major public health problem. A priority objective is the implementation of early diagnosis, contact investigation and latent tuberculosis infection (LTBI) testing. World Health Organization (WHO) concludes that there is no gold standard for the diagnosis of LTBI; both the tuberculin test and IGRA (interferon gamma release assays) indirectly identify tuberculosis infection; both tests are considered acceptable but imperfect. WHO recommends that regimens that include rifamycins are equally effective but less toxic and more adherent than long regimens with isoniazid.
Topics: Humans; Latent Tuberculosis; Isoniazid; Interferon-gamma Release Tests; Tuberculosis; Rifamycins
PubMed: 36285867
DOI: 10.37201/req/s03.20.2022 -
American Journal of Respiratory and... Jul 2021
Topics: Antitubercular Agents; Female; History, 19th Century; History, 20th Century; History, 21st Century; Humans; Latent Tuberculosis; Male; Mycobacterium tuberculosis; Practice Guidelines as Topic; United States
PubMed: 33761302
DOI: 10.1164/rccm.202011-4239PP -
The New England Journal of Medicine May 2015
Review
Topics: Antitubercular Agents; Drug Administration Schedule; Drug Therapy, Combination; Humans; Isoniazid; Latent Tuberculosis; Mycobacterium tuberculosis; Practice Guidelines as Topic; Rifampin; Risk Factors
PubMed: 26017823
DOI: 10.1056/NEJMra1405427 -
Clinical Infectious Diseases : An... Nov 2022
Topics: Humans; Latent Tuberculosis; Tuberculin Test; Mycobacterium tuberculosis
PubMed: 35869842
DOI: 10.1093/cid/ciac582 -
Autoimmunity Reviews Jun 2015Since the introduction of biologics for the treatment of rheumatoid arthritis (RA), psoriatic arthritis (PsA), ankylosing spondylitis (AS), and psoriasis (Pso) an... (Review)
Review
Since the introduction of biologics for the treatment of rheumatoid arthritis (RA), psoriatic arthritis (PsA), ankylosing spondylitis (AS), and psoriasis (Pso) an increased risk of tuberculosis (TB) reactivation in patients with latent tuberculosis infection (LTBI) has been recorded for anti-TNF agents, while a low or absent risk is associated with the non-anti-TNF targeted biologics. To reduce this risk several recommendation sets have been published over time, but in most of them the host-related risk, and the predisposing role to TB reactivation exerted by corticosteroids and by the traditional disease-modifying anti-rheumatic drugs has not been adequately addressed. Moreover, the management of the underlying disease, and the timing of biologic restarting in patients with TB occurrence have been rarely indicated. A multidisciplinary expert panel, the Italian multidisciplinary task force for screening of tuberculosis before and during biologic therapy (SAFEBIO), was constituted, and through a review of the literature, an evidence-based guidance for LTBI detection, identification of the individualized level of risk of TB reactivation, and practical management of patients with TB occurrence was formulated. The literature review confirmed a higher TB risk associated with monoclonal anti-TNF agents, a low risk for soluble receptor etanercept, and a low or absent risk for non-anti-TNF targeted biologics. Considering the TB reactivation risk associated with host demographic and clinical features, and previous or current non-biologic therapies, a low, intermediate, or high TB reactivation risk in the single patient was identified, thus driving the safest biologic choice. Moreover, based on the underlying disease activity measurement and the different TB risk associated with non-biologic and biologic therapies, practical indications for the treatment of RA, PsA, AS, and Pso in patients with TB occurrence, as well as the safest timing of biologic restarting, were provided.
Topics: Arthritis, Rheumatoid; Biological Therapy; Humans; Latent Tuberculosis; Risk Factors; Skin Diseases; Tumor Necrosis Factor-alpha
PubMed: 25617816
DOI: 10.1016/j.autrev.2015.01.011 -
Jornal Brasileiro de Nefrologia 2021
Topics: Humans; Kidney Transplantation; Latent Tuberculosis
PubMed: 34543376
DOI: 10.1590/2175-8239-JBN-2021-E008 -
American Journal of Physiology. Lung... Mar 2022Tuberculosis has been present in the world's population for as long as there has been written language. It is a disease known to the ancient Egyptians, Greeks, Romans,... (Review)
Review
Tuberculosis has been present in the world's population for as long as there has been written language. It is a disease known to the ancient Egyptians, Greeks, Romans, and Hebrews, but its etiology eluded the world for thousands of years. Even after the germ theory was accepted and early scientists hypothesized a pathogen as the cause, the identity of the sleeping killer in society remained a mystery. That is until Robert Koch was able to grow and visualize . Koch introduced his Old Tuberculin solution as a diagnostic therapy of tuberculosis (TB), with the intent to reduce the number of infected persons and stop its spread. Old Tuberculin's ability to treat TB proved minimal, but its diagnostic potential paved the way for more effective tests from von Pirquet, Calmette, Wolff-Eisner, and Mantoux. Florence Seibert set out to identify and purify the active principle in Koch's Old Tuberculin and ended up creating purified protein derivative (PPD) tuberculin which is still used as the standard for the tuberculin skin test (TST). Interferon-γ release assays (IGRAs) are a more modern diagnostic tool for detecting latent TB infection that offer some benefits (and some disadvantages) to TST. TSTs and IGRAs can determine if an individual has been infected with but are equally unable to predict progression to active tuberculosis, the diagnosis of which relies on assessment of clinical symptoms, radiographic imaging, and sample culture.
Topics: Humans; Interferon-gamma Release Tests; Latent Tuberculosis; Mycobacterium tuberculosis; Sensitivity and Specificity; Tuberculin; Tuberculosis
PubMed: 35170334
DOI: 10.1152/ajplung.00217.2021