Infection free "resisters" among household contacts of adult pulmonary tuberculosis.

Autor: Mave V; Byramjee Jeejeebhoy Government Medical College- Johns Hopkins University Clinical Research Site, Pune, Maharashtra, India.; Johns Hopkins School of Medicine, Baltimore, Maryland, United States of America., Chandrasekaran P; National Institute for Research in Tuberculosis, Chennai, Tamil Nadu, India., Chavan A; Byramjee Jeejeebhoy Government Medical College- Johns Hopkins University Clinical Research Site, Pune, Maharashtra, India., Shivakumar SVBY; Johns Hopkins University-India office (CCGHE), Pune, Maharashtra, India., Danasekaran K; National Institute for Research in Tuberculosis, Chennai, Tamil Nadu, India., Paradkar M; Byramjee Jeejeebhoy Government Medical College- Johns Hopkins University Clinical Research Site, Pune, Maharashtra, India., Thiruvengadam K; National Institute for Research in Tuberculosis, Chennai, Tamil Nadu, India., Kinikar A; Byramjee Jeejeebhoy Government Medical College, Pune, Maharashtra, India., Murali L; District Tuberculosis Officer, State Tuberculosis Office, Thiruvallur, Tamil Nadu, India., Gaikwad S; Byramjee Jeejeebhoy Government Medical College, Pune, Maharashtra, India., Hanna LE; National Institute for Research in Tuberculosis, Chennai, Tamil Nadu, India., Kulkarni V; Byramjee Jeejeebhoy Government Medical College- Johns Hopkins University Clinical Research Site, Pune, Maharashtra, India., Pattabiraman S; National Institute for Research in Tuberculosis, Chennai, Tamil Nadu, India., Suryavanshi N; Byramjee Jeejeebhoy Government Medical College- Johns Hopkins University Clinical Research Site, Pune, Maharashtra, India., Thomas B; National Institute for Research in Tuberculosis, Chennai, Tamil Nadu, India., Kohli R; Byramjee Jeejeebhoy Government Medical College- Johns Hopkins University Clinical Research Site, Pune, Maharashtra, India., Sivaramakrishnan GN; National Institute for Research in Tuberculosis, Chennai, Tamil Nadu, India., Pradhan N; Byramjee Jeejeebhoy Government Medical College- Johns Hopkins University Clinical Research Site, Pune, Maharashtra, India., Bhanu B; National Institute for Research in Tuberculosis, Chennai, Tamil Nadu, India., Kagal A; Byramjee Jeejeebhoy Government Medical College, Pune, Maharashtra, India., Golub J; Johns Hopkins School of Medicine, Baltimore, Maryland, United States of America.; Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America., Gandhi N; Emory University, Atlanta, Georgia, United States of America., Gupte A; Johns Hopkins School of Medicine, Baltimore, Maryland, United States of America., Gupte N; Byramjee Jeejeebhoy Government Medical College- Johns Hopkins University Clinical Research Site, Pune, Maharashtra, India.; Johns Hopkins School of Medicine, Baltimore, Maryland, United States of America., Swaminathan S; Indian Council of Medical Research, New Delhi, India., Gupta A; Johns Hopkins School of Medicine, Baltimore, Maryland, United States of America.; Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America.
Jazyk: angličtina
Zdroj: PloS one [PLoS One] 2019 Jul 18; Vol. 14 (7), pp. e0218034. Date of Electronic Publication: 2019 Jul 18 (Print Publication: 2019).
DOI: 10.1371/journal.pone.0218034
Abstrakt: Despite substantial exposure to infectious pulmonary tuberculosis (TB) cases, some household contacts (HHC) never acquire latent TB infection (LTBI). Characterizing these "resisters" can inform who to study immunologically for the development of TB vaccines. We enrolled HHCs of culture-confirmed adult pulmonary TB in India who underwent LTBI testing using tuberculin skin test (TST) and QuantiFERON TB Gold Test-in-tube (QFT-GIT) at baseline and, if negative by both (<5mm TST and <0.35IU/mL QFT-GIT), underwent follow-up testing at 4-6 and/or 12 months. We defined persons with persistently negative LTBI tests at both baseline and followup as pLTBI- and resisters as those who had a high exposure to TB using a published score and remained pLTBI-. We calculated the proportion of resisters overall and resisters with complete absence of response to LTBI tests (0mm TST and/or QFT-GIT <0.01 IU/ml). Using random effects Poisson regression, we assessed factors associated with pLTBI-. Of 799 HHCs in 355 households, 67 (8%) were pLTBI- at 12 months; 52 (6.5%) pLTBI- in 39 households were resisters. Complete absence of response to LTBI tests was found in 27 (53%) resisters. No epidemiological characteristics were associated with the pLTBI- phenotype. LTBI free resisters among HHC exist but are uncommon and are without distinguishing epidemiologic characteristics. Assessing the genetic and immunologic features of such resister individuals is likely to elucidate mechanisms of protective immunity to TB.
Competing Interests: All authors declare that they have no competing interests to declare.
Databáze: MEDLINE
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