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Madhukar Pai, Marcel Behr
The identification of individuals with latent tuberculosis infection (LTBI) is useful for both fundamental understanding of the pathogenesis of disease and for clinical and public health interventions (i.e., to prevent progression to disease). Basic research suggests there is a pathogenetic continuum from exposure to infection to disease, and individuals may advance or reverse positions within the spectrum, depending on changes in the host immunity. Unfortunately, there is no diagnostic test that resolves the various stages within the spectrum of Mycobacterium tuberculosis infection...
October 2016: Microbiology Spectrum
Aliya Yamin, Ethan Bornstein, Rachel Hensel, Omar Mohamed, Russell R Kempker
Background.  Despite the low and decreasing prevalence of tuberculosis (TB) in the United States, there remain certain high-risk groups with high incidence rates. The targeted screening and treatment of latent TB infection (LTBI) among these high-risk groups are needed to achieve TB elimination; however, by most accounts, LTBI treatment completion rates remain low. Methods.  We retrospectively studied all patients accepting treatment for LTBI at the Fulton County Health Department TB clinic over 2 years...
October 2016: Open Forum Infectious Diseases
P Mencarini, R Bellagamba, A Oliva, P Ghirga, M L Giancola, A Corpolongo, T Ascoli Bartoli, P De Nardo, A Baiocchini, F Del Nonno, P Narciso, E Nicastri
The diagnosis of sarcoidosis in a patient living with HIV infection is an uncommon event and a challenge for clinicians. Clinical manifestations are variable and fluctuating depending to adherence to ARV therapy and to the level of CD4 count. We analyze here one chronic case in which sarcoidosis appeared clinically two years after pulmonary tuberculosis. The course of the disease was influenced and prolonged by frequent interruptions of antiretroviral therapy. Moreover the diagnosis and the decision to treat have been delayed by the need of exclusion of other pathologies, principally tuberculosis reactivation/reinfection, other mycobacterial diseases, hematologic malignancies...
2016: Respiratory Medicine Case Reports
Roberta Petrucci, Giulia Lombardi, Ilaria Corsini, Maria Letizia Bacchi Reggiani, Francesca Visciotti, Filippo Bernardi, Maria Paola Landini, Salvatore Cazzato, Paola Dal Monte
BACKGROUND: The diagnostic accuracy of Quantiferon-TB Gold In-Tube (QFT-IT) is uncertain in the pediatric population, while tuberculin skin test (TST) is still conventionally used despite its limitations. The aim of this study was to compare the performance of QFT-IT with TST in a large cohort of children screened for TB infection because of contact tracing, suspected TB, arrival from endemic country or immunosuppressive therapy. METHODS: A retrospective analysis was conducted on 517 children 0-14 years of age evaluated at the pediatric unit of the S...
October 3, 2016: Pediatric Infectious Disease Journal
Paula Flanagan, Joan O'Donnell, Jolita Mereckiene, Darina O'Flanagan
The risk of communicable disease transmission during air travel is of public health concern and has received much attention over the years. We retrospectively reviewed information from nine flights (≥ 8 hours) associated with infectious tuberculosis (TB) cases in Ireland between September 2011 and November 2014 to investigate whether possible transmission had occurred. Twenty-four flights notified in Ireland associated with sputum smear-positive pulmonary TB cases with a history of air travel were reviewed...
October 6, 2016: Euro Surveillance: Bulletin Européen sur les Maladies Transmissibles, European Communicable Disease Bulletin
Ank E Nijhawan, Princess A Iroh, Larry S Brown, Daniel Winetsky, Esmaeil Porsa
BACKGROUND: Tuberculosis (TB) disproportionately affects immigrants, HIV-infected individuals, and those living in crowded settings such as homeless shelters and correctional facilities. Although the majority of jails and prisons use a tuberculin skin test (TST) for latent tuberculosis infection (LTBI) screening, limited data exist on the clinical performance and costs of the TST compared to interferon gamma release assays (IGRAs) in this setting. METHODS: A prospective pilot study comparing cost between TST and an IGRA (QuantiFERON Gold In-tube, QFT-GIT) for the detection of LTBI in a convenience sample of inmates entering the Dallas County Jail (DCJ) was conducted June-October 2014...
October 12, 2016: BMC Infectious Diseases
Saroochi Agarwal, Duc T Nguyen, Justin D Lew, Larry D Teeter, Jose-Miguel Yamal, Blanca I Restrepo, Eric L Brown, Susan E Dorman, Edward A Graviss
BACKGROUND: The interferon gamma release assay, TSPOT.TB (TSPOT) can be read by several methodologies, including an Elispot reader or manually by technician. We compared the results from these two counting methods. METHODS: Automated and manual TSPOT results among 2481 United States health care workers were compared. Cohen's kappa coefficient was used to determine the inter-rater agreement. Univariate and multiple logistic regression were used to investigate selected variable contributions...
September 28, 2016: Tuberculosis
Elisa Petruccioli, Teresa Chiacchio, Ilaria Pepponi, Valentina Vanini, Rocco Urso, Gilda Cuzzi, Lucia Barcellini, Daniela Maria Cirillo, Fabrizio Palmieri, Giuseppe Ippolito, Delia Goletti
INTRODUCTION: QuantiFERON(®)-TB Gold Plus (QFT-Plus) is the new generation of QuantiFERON-TB Gold In-Tube test to identify latent tuberculosis infection (LTBI). QFT-Plus includes TB1 and TB2 tubes which contain selected Mycobacterium tuberculosis (Mtb) peptides designed to stimulate both CD4 and CD8 T-cells. Aim of this study is the flow cytometric characterization of the specific CD4 and CD8 T-cell responses to Mtb antigens contained within QFT-Plus. METHODS: We enrolled 27 active tuberculosis (TB) patients and 30 LTBI individuals...
October 4, 2016: Journal of Infection
Sharifa Nasreen, Mostafa Shokoohi, Monali S Malvankar-Mehta
BACKGROUND: Tuberculosis is one of the leading causes of death worldwide. Twenty-two high burden countries contributed to the majority of worldwide tuberculosis cases in 2015. Health care workers are at high risk of acquiring tuberculosis through occupational exposure. OBJECTIVE: To estimate the prevalence of latent tuberculosis infection (LTBI) among health care workers in high burden countries. METHODS: Databases including MEDLINE (Ovid), EMBASE (Ovid), CINAHL (Ovid) and ISI Web of Science (Thompson-Reuters), and grey literature were searched for English language records on relevant medical subject headings (MeSH) terms of LTBI and health care providers...
2016: PloS One
Chin-Chung Shu, Chia-Lin Hsu, Chih-Yuan Lee, Vin-Cent Wu, Feng-Jung Yang, Jann-Yuan Wang, Chong-Jen Yu, Li-Na Lee
The interferon-gamma release assay (IGRA) is useful for diagnosing latent tuberculosis infection (LTBI), however the rate of negative conversion is high, especially in dialysis patients. Few studies have focused on predicting persistently positive patients who are at high risk of tuberculosis reactivation. We screened dialysis patients, and used QuantiFERON-TB Gold In-tube (QFT-GIT) to identify LTBI. Of the 157 participants who had initially positive QFT-GIT, 82 had persistently positivity and 75 had negative conversion...
October 5, 2016: Scientific Reports
Mangalakumari Jeyanathan, Daniela Damjanovic, Yushi Yao, Jonathan Bramson, Fiona Smaill, Zhou Xing
BACKGROUND:  Whether a candidate TB vaccine induces clinically relevant protective T cell repertoires in humans is not known until the completion of costly efficacy clinical trials. METHODS:  We have developed an integrated immunologic approach to investigate the clinical relevance of a novel TB vaccine-induced T cells in a phase 1 trial. This approach consists of screening for likely dominant T cell epitopes, establishing Ag-specific memory T cell lines for identifying CD8 and CD4 T cell epitopes, determining the ability of vaccine-induced T cells to inhibit mycobacterial growth in infected cells, and examining the genetic diversity of HLA recognition and clinical relevance of identified T cell epitopes...
October 4, 2016: Journal of Infectious Diseases
Paolo Durando, Sergio Garbarino, Andrea Orsi, Cristiano Alicino, Guglielmo Dini, Alessandra Toletone, Fabrizio Ciprani, Giuseppe Conte, Roberto Santorsa, Giancarlo Icardi
OBJECTIVES: Better knowledge about tuberculosis (TB) and latent TB infection (LTBI) epidemiology is a crucial step for the development of effective strategies towards the control and elimination of this deadliest and persistent health threat. No study has investigated LTBI epidemiology in policemen who act as an interface with cross-border migrants. METHODS: A survey to measure the LTBI prevalence and assess the demographic, professional and clinical features potentially associated with tuberculin skin test (TST) positivity was performed in Italian State Police (ISP) employees engaged, even occasionally, in relief activities, hospitality, photographical identification, escorting and accompanying of migrants, regardless of contact with active TB cases...
October 3, 2016: BMJ Open
Ula Maniewski, Marie-Christine Payen, Marc Delforge, Stephane De Wit
OBJECTIVES: A decreasing incidence of tuberculosis (TB) among HIV patients has been documented in high-income settings and screening for tuberculosis is not systematically performed in many clinics (such as ours). Our objectives are to evaluate whether a same decline of incidence was seen in our Belgian tertiary center and to evaluate whether systematic screening and prophylaxis of tuberculosis should remain part of routine practice. METHODS: Between 2005 and 2012, the annual incidence of tuberculosis among adult HIV patients was measured...
September 30, 2016: Acta Clinica Belgica
Ida Wergeland, Jörg Assmus, Anne Ma Dyrhol-Riise
BACKGROUND: Interferon gamma release assays (IGRAs) do not discriminate between active tuberculosis (TB) and latent TB infection (LTBI), which limit their use in TB endemic areas. Subjects with QuantiFERON-TB (QFT) results around the diagnostic cut-off more likely show inconsistent results on serial testing which makes the interpretation of the assay difficult. We have studied potential biomarkers in patients with various stages of TB infection and with borderline QFT tests compared to those with higher values...
2016: PloS One
Alessandro Sanduzzi, Antonio Ponticiello, Marialuisa Bocchino, Francesco Perna, Alessandro Vatrella
Screening of latent infection by Mycobacterium tuberculosis (LTBI) and treatment of positive subjects is the key point in the prevention of TB; such a strategy should be performed mainly among individuals with risk of progression. Progression from LTBI to active TB is highest both in recent contacts of patients with active TB, and in immunocompromised subjects. Therefore, LTBI could either be considered a permanent host defence or, seen from the opposite point of view, it could represent a long-lasting threat if the efficiency of the immune system declines over a lifetime...
September 1, 2016: Le Infezioni in Medicina
Miguel Santin, Francisco Morandeira-Rego, Fernando Alcaide, Ramón Rabuñal, Luís Anibarro, Ramón Agüero-Balbín, Xavier Casas-Garcia, Elvira Pérez-Escolano, Maria D Navarro, Francisca Sánchez, Amparo Coira-Nieto, Matilde Trigo-Daporta, Amaya Martinez-Meñaca, Araceli Gonzalez-Cuevas, Maria D López-Prieto, Ángel Domínguez-Castellano, Neus Jové
OBJECTIVE: Previous reports have identified interleukin-2 (IL-2), quantified in the supernatants of QuantiFERON(®)-TB Gold In-tube (QFT) after 72 hours of incubation, as a potential biomarker for distinguishing between latent and active tuberculosis (TB). However, its validity has not been tested in an appropriate clinical cohort. METHODS: A multicentre study of 161 consecutive adult patients undergoing evaluation for active TB at eight TB Units in Spain. IFN-γ and IL-2 were assessed in the supernatant of QFT after 16-24 h and 72 h incubation...
September 16, 2016: Clinical Microbiology and Infection
Giovanni Delogu, Valentina Vanini, Gilda Cuzzi, Teresa Chiacchio, Flavio De Maio, Basem Battah, Carmela Pinnetti, Alessandro Sampaolesi, Andrea Antinori, Delia Goletti
RATIONALE: Heparin-binding haemagglutinin (HBHA) has been proposed as an immunological biomarker for discriminating active tuberculosis (TB) from latent TB infection (LTBI) and to identify those at higher risk of progressing to active disease. Few data are available in immune compromised patients, which are those with increased risk of TB reactivation. OBJECTIVE: To evaluate the immune response to HBHA in HIV-infected subjects with LTBI (HIV-LTBI) or active TB (HIV-TB) in comparison with the immune response to additional Mycobacterium tuberculosis (Mtb) or HIV and CMV antigens...
September 16, 2016: Scandinavian Journal of Immunology
Erfan Ayubi, Amin Doosti-Irani, Ali Sanjari Moghaddam, Mohadeseh Sani, Milad Nazarzadeh, Ehsan Mostafavi
BACKGROUND: Accurate diagnosis of latent tuberculosis infection (LTBI) is becoming increasingly concerning due to the increasing the HIV epidemic, which have increased the risk for reactivation to active tuberculosis (TB) infection. LTBI is diagnosed by tuberculin skin test (TST) and interferon-gamma release assays (IGRAs). OBJECTIVES: The aim of the present study was to conduct a meta-analysis of published papers on the agreement (kappa) between TST and QuantiFERON-TB Gold In-Tube (QFT-GIT) tests for diagnosis of LTBI in HIV patient...
2016: PloS One
Séverine Carrère-Kremer, Pierre-Alain Rubbo, Amandine Pisoni, Sophie Bendriss, Grégory Marin, Marianne Peries, Karine Bolloré, Dominique Terru, Sylvain Godreuil, Arnaud Bourdin, Philippe Van de Perre, Edouard Tuaillon
Interferon gamma (IFN-γ) release assays (IGRAs) detect Mycobacterium tuberculosis (Mtb) infection regardless of the active (ATB) or latent (LTBI) forms of tuberculosis (TB). In this study, Mtb-specific T cell response against region of deletion 1 (RD1) antigens were explored by a microbead multiplex assay performed in T-SPOT TB assay (T-SPOT) supernatants from 35 patients with ATB and 115 patients with LTBI. T-SPOT is positive when over 7 IFN-γ secreting cells (SC)/250 000 peripheral blood mononuclear cells (PBMC) are enumerated...
2016: PloS One
Taylor W Foreman, Smriti Mehra, Denae N LoBato, Adel Malek, Xavier Alvarez, Nadia A Golden, Allison N Bucşan, Peter J Didier, Lara A Doyle-Meyers, Kasi E Russell-Lodrigue, Chad J Roy, James Blanchard, Marcelo J Kuroda, Andrew A Lackner, John Chan, Shabaana A Khader, William R Jacobs, Deepak Kaushal
The synergy between Mycobacterium tuberculosis (Mtb) and HIV in coinfected patients has profoundly impacted global mortality because of tuberculosis (TB) and AIDS. HIV significantly increases rates of reactivation of latent TB infection (LTBI) to active disease, with the decline in CD4(+) T cells believed to be the major causality. In this study, nonhuman primates were coinfected with Mtb and simian immunodeficiency virus (SIV), recapitulating human coinfection. A majority of animals exhibited rapid reactivation of Mtb replication, progressing to disseminated TB and increased SIV-associated pathology...
September 20, 2016: Proceedings of the National Academy of Sciences of the United States of America
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