Escaping the Plato's cave of latent tuberculosis testing: a path for developers of predictive tests for risk of tuberculosis

Rühwald, Morten; Diel, Roland

doi:10.1183/13993003.01616-2018

Cited by 3 publications

(2 citation statements)

References 25 publications

(36 reference statements)

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“…6 With IGRAs being poor predictors of development of active tuberculosis, 7 a test for incipient tuberculosis is on the most-wanted diagnostics list. 8,9 Assessment of the stage of infection could be achieved through testing responses to stage-specific antigens, such as latency antigens, resuscitation promoting factors, and replication associated antigens. 10 Other possible targets are cytokines other than interferon-, 11 specific T-cell populations, or host biomarkers, such as prognostic correlates of risk www.thelancet.com/infection Vol 19 February 2019 based on mRNA expression signatures, which are now being evaluated for prediction of active tuberculosis.…”

Section: New Developments On Interferon-γ Release Assays For Tubercul...mentioning

confidence: 99%

New developments on interferon-γ release assays for tuberculosis diagnosis

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2019

The Lancet Infectious Diseases

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Section: New Developments On Interferon-γ Release Assays For Tubercul...mentioning

confidence: 99%

New developments on interferon-γ release assays for tuberculosis diagnosis

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2019

The Lancet Infectious Diseases

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“…In 2016, the global prevalence of LTBI was updated to 23%, which corresponds to 1.7 billion people infected worldwide [ 6 ]. Studies have shown that <3% of these people will develop active TB over the course of their lifetime, the risk being 20–100 times higher among PLHIV [ 4 , 7 , 8 , 9 , 10 , 11 ].…”

Section: Introductionmentioning

confidence: 99%

Latent Tuberculosis Infection and Associated Risk Factors among People Living with HIV and HIV-Uninfected Individuals in Lithuania

Matulyte,

Kancauskiene,

Kausas

et al. 2023

Pathogens

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Background: People living with HIV (PLHIV) with latent tuberculosis infection (LTBI) are at increased risk of tuberculosis (TB) reactivation compared to the HIV-negative population. Lithuania belongs to the 18 high-priority TB countries in the European region. The aim of this study was to compare the prevalence of LTBI and LTBI-related risk factors between PLHIV and HIV-uninfected populations. Methods: A cross-sectional study was conducted in three Lithuanian Infectious Diseases centres from August 2018 to May 2022 using the interferon gamma release assay (IGRA) and tuberculin skin test (TST) in Vilnius, and IGRA only in Siauliai and Klaipeda. Cohen’s kappa was used to assess IGRA and TST agreement. A structured questionnaire was completed by the study participants. LTBI-related risk factors were identified using a multivariable logistic regression model. Results: In total, 391 PLHIV and 443 HIV-uninfected individuals enrolled, with a median age of 41 (IQR 36–48) and 43 (IQR 36–50), consisting of 69.8% and 65.5% male, respectively. The prevalence of LTBI defined by positive IGRA and/or TST among PLHIV was higher compared to that in the HIV-uninfected population (20.5% vs. 15.3%; OR 1.42; 95% CI 1.02–2.03; p = 0.04). The concordance between IGRA and TST was fair: kappa = 0.23 (95% CI 0.09–0.34). In multivariable analyses, association with injecting drug use (IDU) (ORa 2.25, 95% CI 1.27–3.99, p = 0.01) and imprisonment (ORa 1.99, 95% CI 1.13–3.52, p = 0.02) in all participants, IDU (ORa 2.37, 95% CI 1.09–5.15; p = 0.029) in PLHIV and a history of contact with an active TB patient (ORa 3.33, 95% CI 1.53–7.24; p = 0.002) in HIV-uninfected individuals were significant associations evidenced by LTBI. Conclusions: The prevalence of LTBI among PLHIV in Lithuania is higher compared to that in the HIV-uninfected population and the European average. The association with IDU in PLHIV emphasizes the need for integrated HIV, TB and substance abuse treatment to provide patient-centred care.

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It is time to optimise the management of latent tuberculosis infection in children

Nordholm

Lillebæk

2021

Eur Respir J

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Escaping the Plato's cave of latent tuberculosis testing: a path for developers of predictive tests for risk of tuberculosis

Abstract: @ERSpublicationsThe End TB Strategy calls for renewed focus on latent TB, which requires development of more predictive tests. KIK et al. provide a framework for the clinical development of such tests, an ambition that calls for joint efforts by researchers and funders.

Cited by 3 publications

References 25 publications

New developments on interferon-γ release assays for tuberculosis diagnosis

New developments on interferon-γ release assays for tuberculosis diagnosis

Latent Tuberculosis Infection and Associated Risk Factors among People Living with HIV and HIV-Uninfected Individuals in Lithuania

It is time to optimise the management of latent tuberculosis infection in children

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