5-Year Follow-up of Active Tuberculosis Development From Latent Infection in Rural China

Xin, Henan; Zhang, Haoran; Liu, Jianmin; Lü, Wei; Bai, Lianhua; Cao, Xuefang; Feng, Boxuan; Jin, Qi; Gao, Lei

doi:10.1093/cid/ciz581

Cited by 18 publications

(14 citation statements)

References 11 publications

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“…In the present study, we detected increased proportions of positive IGRA results and high OR values in children with household or non-household contact risk. Population-based multicenter studies performed in China have revealed that individuals with baseline results of IGRA+ /TST− showed a similar or higher incidence of active TB than those with baseline results IGRA+/TST+ or IGRA− /TST+ , either within the first 2 years of follow-up [ 12 ] or 5 years of follow-up [ 13 ]. Data from in our study which showed that discordance favored IGRA+/TST− in those with active TB whereas among those without active TB discordance favors TST+/IGRA−, suggested higher sensitivity and specificity of IGRA than that of TST.…”

Section: Discussionmentioning

confidence: 99%

Tuberculosis infection screening in children with close contact: a hospital-based study

et al. 2021

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Background Identifying and prioritizing at-risk populations is critical for pediatric tuberculosis control. We aimed to identify a latent tuberculosis infection (LTBI) screening strategy that is appropriate for the Chinese context among children with different TB exposure levels and to explore its clinical importance. Methods During 2013–2015, we enrolled hospitalized children with suspected respiratory infectious disease (RID) for LTBI screening using the tuberculin skin test (TST) and interferon-γ release assay (IGRA) T-SPOT.TB as part of a work up for their RID. Participants with confirmed diagnosis were classified into three subgroups according to level of exposure to TB: no reported contact risk, with household contact risk, and with non-household contact risk. Results A total 6202 children (median age: 4.76 years; interquartile range: 1.0–8.0 years) were enrolled. Children with no reported contact risk had the lowest proportions of positive results for the IGRA (0.7%) and TST (3.3%). The proportion of positive results for each test was higher for household contacts than non-household contacts. The TST positive proportion was much higher than that for the IGRA in all three groups. Children with IGRA+/TST+ results had larger indurations than those with IGRA− /TST+ results (15 mm vs. 13 mm, P = 0.02). For IGRA, older age (> 5 years) and non-household or household contact risk were associated with a positive result. Conclusions Positive IGRA results in children with a contact risk can serve as a critical reference for LTBI management. IGRA can be used, in preference to TST, for Chinese children with a TB exposure risk.

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Section: Discussionmentioning

confidence: 99%

Tuberculosis infection screening in children with close contact: a hospital-based study

et al. 2021

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“…Most subjects suffered with MTB infection stay clinically asymptomatic which is called latent TB infection (LTBI). A relatively small proportion of these individuals would develop to active TB (ATB) during their life ( 3 , 4 ). TB control strategies largely focus on identification and treatment of people with ATB.…”

Section: Introductionmentioning

confidence: 99%

Lymphocyte-Related Immunological Indicators for Stratifying Mycobacterium tuberculosis Infection

et al. 2021

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BackgroundEasily accessible tools that reliably stratify Mycobacterium tuberculosis (MTB) infection are needed to facilitate the improvement of clinical management. The current study attempts to reveal lymphocyte-related immune characteristics of active tuberculosis (ATB) patients and establish immunodiagnostic model for discriminating ATB from latent tuberculosis infection (LTBI) and healthy controls (HC).MethodsA total of 171 subjects consisted of 54 ATB, 57 LTBI, and 60 HC were consecutively recruited at Tongji hospital from January 2019 to January 2021. All participants were tested for lymphocyte subsets, phenotype, and function. Other examination including T-SPOT and microbiological detection for MTB were performed simultaneously.ResultsCompared with LTBI and HC, ATB patients exhibited significantly lower number and function of lymphocytes including CD4+ T cells, CD8+ T cells and NK cells, and significantly higher T cell activation represented by HLA-DR and proportion of immunosuppressive cells represented by Treg. An immunodiagnostic model based on the combination of NK cell number, HLA-DR+CD3+ T cells, Treg, CD4+ T cell function, and NK cell function was built using logistic regression. Based on receiver operating characteristic curve analysis, the area under the curve (AUC) of the diagnostic model was 0.920 (95% CI, 0.867-0.973) in distinguishing ATB from LTBI, while the cut-off value of 0.676 produced a sensitivity of 81.48% (95% CI, 69.16%-89.62%) and specificity of 91.23% (95% CI, 81.06%-96.20%). Meanwhile, AUC analysis between ATB and HC according to the diagnostic model was 0.911 (95% CI, 0.855-0.967), with a sensitivity of 81.48% (95% CI, 69.16%-89.62%) and a specificity of 90.00% (95% CI, 79.85%-95.34%).ConclusionsOur study demonstrated that the immunodiagnostic model established by the combination of lymphocyte-related indicators could facilitate the status differentiation of MTB infection.

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“…TB remains an important infectious disease worldwide ( Haas et al., 2016 ; Furin et al., 2019 ). To achieve TB elimination strategy, rapid, inexpensive, and accurate methods for differentiating between ATB and LTBI are urgently required, especially in high-endemic countries such as China ( World Health Organization, 2016 ; Gao et al., 2017 ; Xin et al., 2019 ). The conventional pathogen-detecting methods have limitations in clinical application ( MacLean et al., 2019 ).…”

Section: Discussionmentioning

confidence: 99%

Combination of Blood Routine Examination and T-SPOT.TB Assay for Distinguishing Between Active Tuberculosis and Latent Tuberculosis Infection

Luo

Tang

et al. 2021

Front. Cell. Infect. Microbiol.

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BackgroundDistinguishing between active tuberculosis (ATB) and latent tuberculosis infection (LTBI) remains challenging.MethodsBetween 2013 and 2019, 2,059 (1,097 ATB and 962 LTBI) and another 883 (372 ATB and 511 LTBI) participants were recruited based on positive T-SPOT.TB (T-SPOT) results from Qiaokou (training) and Caidian (validation) cohorts, respectively. Blood routine examination (BRE) was performed simultaneously. Diagnostic model was established according to multivariate logistic regression.ResultsSignificant differences were observed in all indicators of BRE and T-SPOT assay between ATB and LTBI. Diagnostic model built on BRE showed area under the curve (AUC) of 0.846 and 0.850 for discriminating ATB from LTBI in the training and validation cohorts, respectively. Meanwhile, TB-specific antigens spot-forming cells (SFC) (the larger of early secreted antigenic target 6 and culture filtrate protein 10 SFC in T-SPOT assay) produced lower AUC of 0.775 and 0.800 in the training and validation cohorts, respectively. The diagnostic model based on combination of BRE and T-SPOT showed an AUC of 0.909 for differentiating ATB from LTBI, with 78.03% sensitivity and 90.23% specificity when a cutoff value of 0.587 was used in the training cohort. Application of the model to the validation cohort showed similar performance. The AUC, sensitivity, and specificity were 0.910, 78.23%, and 90.02%, respectively. Furthermore, we also assessed the performance of our model in differentiating ATB from LTBI with lung lesions. Receiver operating characteristic analysis showed that the AUC of established model was 0.885, while a threshold of 0.587 yield a sensitivity of 78.03% and a specificity of 85.69%, respectively.ConclusionsThe diagnostic model based on combination of BRE and T-SPOT could provide a reliable differentiation between ATB and LTBI.

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5-Year Follow-up of Active Tuberculosis Development From Latent Infection in Rural China

Cited by 18 publications

References 11 publications

Tuberculosis infection screening in children with close contact: a hospital-based study

Tuberculosis infection screening in children with close contact: a hospital-based study

Lymphocyte-Related Immunological Indicators for Stratifying Mycobacterium tuberculosis Infection

Combination of Blood Routine Examination and T-SPOT.TB Assay for Distinguishing Between Active Tuberculosis and Latent Tuberculosis Infection

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