High resolution imaging and five-year tuberculosis contact outcomes.

Autor:	Esmail H; Centre for Infectious Diseases Research in Africa, Institute of Infectious Disease and Molecular Medicine, University of Cape Town, Observatory 7925, Republic of South Africa.; MRC Clinical Trials Unit at University College London, WC1V 6LJ, United Kingdom.; WHO Collaborating Centre for Tuberculosis Research and Innovation, Institute for Global Health, University College London, WC1E 6JB, United Kingdom., Coussens AK; Centre for Infectious Diseases Research in Africa, Institute of Infectious Disease and Molecular Medicine, University of Cape Town, Observatory 7925, Republic of South Africa.; Infectious Diseases and Immune Defence Division, The Walter and Eliza Hall Institute of Medical Research, Parkville, Victoria 3052, Australia.; Department of Medical Biology, University of Melbourne, Parkville, 3052, Australia., Thienemann F; Centre for Infectious Diseases Research in Africa, Institute of Infectious Disease and Molecular Medicine, University of Cape Town, Observatory 7925, Republic of South Africa.; Department of Internal Medicine, University Hospital of Zurich, University of Zurich, Switzerland., Sossen B; Centre for Infectious Diseases Research in Africa, Institute of Infectious Disease and Molecular Medicine, University of Cape Town, Observatory 7925, Republic of South Africa., Mukasa SL; Centre for Infectious Diseases Research in Africa, Institute of Infectious Disease and Molecular Medicine, University of Cape Town, Observatory 7925, Republic of South Africa., Warwick J; Division of Nuclear Medicine, Department of Medical Imaging and Clinical Oncology, Stellenbosch University, Cape Town, South Africa., Goliath RT; Centre for Infectious Diseases Research in Africa, Institute of Infectious Disease and Molecular Medicine, University of Cape Town, Observatory 7925, Republic of South Africa., Davies NO; Centre for Infectious Diseases Research in Africa, Institute of Infectious Disease and Molecular Medicine, University of Cape Town, Observatory 7925, Republic of South Africa., Douglass E; Division of Infectious Diseases, Center for Emerging Pathogens, New Jersey Medical School, Rutgers University, Newark, NJ, USA., Jackson A; Centre for Infectious Diseases Research in Africa, Institute of Infectious Disease and Molecular Medicine, University of Cape Town, Observatory 7925, Republic of South Africa., Lakay F; Centre for Infectious Diseases Research in Africa, Institute of Infectious Disease and Molecular Medicine, University of Cape Town, Observatory 7925, Republic of South Africa., Streicher E; Department of Science and Technology/National Research Foundation Centre of Excellence in Biomedical Tuberculosis Research, South African Medical Research Council for Tuberculosis Research, Division of Molecular Biology and Human Genetics, Department of Biomedical Sciences, Faculty of Health Sciences, Stellenbosch University, Cape Town, South Africa., Munro JE; Department of Medical Biology, University of Melbourne, Parkville, 3052, Australia.; Population Health and Immunity Division, The Walter and Eliza Hall Institute of Medical Research, Parkville, Victoria 3052, Australia., Barrios MH; Department of Medical Biology, University of Melbourne, Parkville, 3052, Australia.; Advanced Genomics Facility, Advanced Technology and Biology Division, The Walter and Eliza Hall Institute of Medical Research, Parkville, Victoria 3052, Australia., Heinsohn T; Department of Epidemiology, Helmholtz Centre for Infection Research, Braunschweig, Germany., Macpherson L; MRC Clinical Trials Unit at University College London, WC1V 6LJ, United Kingdom., Sheerin D; Infectious Diseases and Immune Defence Division, The Walter and Eliza Hall Institute of Medical Research, Parkville, Victoria 3052, Australia.; Department of Medical Biology, University of Melbourne, Parkville, 3052, Australia., Aziz S; Centre for Infectious Diseases Research in Africa, Institute of Infectious Disease and Molecular Medicine, University of Cape Town, Observatory 7925, Republic of South Africa., Serole K; Centre for Infectious Diseases Research in Africa, Institute of Infectious Disease and Molecular Medicine, University of Cape Town, Observatory 7925, Republic of South Africa., Daroowala R; Centre for Infectious Diseases Research in Africa, Institute of Infectious Disease and Molecular Medicine, University of Cape Town, Observatory 7925, Republic of South Africa., Taliep A; Centre for Infectious Diseases Research in Africa, Institute of Infectious Disease and Molecular Medicine, University of Cape Town, Observatory 7925, Republic of South Africa., Ahlers P; Department of Science and Technology/National Research Foundation Centre of Excellence in Biomedical Tuberculosis Research, South African Medical Research Council for Tuberculosis Research, Division of Molecular Biology and Human Genetics, Department of Biomedical Sciences, Faculty of Health Sciences, Stellenbosch University, Cape Town, South Africa., Malherbe ST; Department of Science and Technology/National Research Foundation Centre of Excellence in Biomedical Tuberculosis Research, South African Medical Research Council for Tuberculosis Research, Division of Molecular Biology and Human Genetics, Department of Biomedical Sciences, Faculty of Health Sciences, Stellenbosch University, Cape Town, South Africa., Bowden R; Department of Medical Biology, University of Melbourne, Parkville, 3052, Australia.; Advanced Genomics Facility, Advanced Technology and Biology Division, The Walter and Eliza Hall Institute of Medical Research, Parkville, Victoria 3052, Australia., Warren R; Department of Science and Technology/National Research Foundation Centre of Excellence in Biomedical Tuberculosis Research, South African Medical Research Council for Tuberculosis Research, Division of Molecular Biology and Human Genetics, Department of Biomedical Sciences, Faculty of Health Sciences, Stellenbosch University, Cape Town, South Africa., Walzl G; Department of Science and Technology/National Research Foundation Centre of Excellence in Biomedical Tuberculosis Research, South African Medical Research Council for Tuberculosis Research, Division of Molecular Biology and Human Genetics, Department of Biomedical Sciences, Faculty of Health Sciences, Stellenbosch University, Cape Town, South Africa., Via LE; Tuberculosis Research Section, Laboratory of Clinical Immunology and Microbiology, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD.; Tuberculosis Imaging Program, Division of Intramural Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD., Bahlo M; Department of Medical Biology, University of Melbourne, Parkville, 3052, Australia.; Population Health and Immunity Division, The Walter and Eliza Hall Institute of Medical Research, Parkville, Victoria 3052, Australia., Jacobson KR; Section of Infectious Diseases, Boston University Chobanian and Avedisian School of Medicine and Boston Medical Center, Boston, MA, USA.; Department of Epidemiology, Boston University School of Public Health Boston, MA, USA., Horsburgh CR Jr; Department of Epidemiology, Boston University School of Public Health Boston, MA, USA., Salgame P; Division of Infectious Diseases, Center for Emerging Pathogens, New Jersey Medical School, Rutgers University, Newark, NJ, USA., Alland D; Public Health Research Institute, New Jersey Medical School, Rutgers University, Newark, NJ, USA., Barry CE 3rd; Centre for Infectious Diseases Research in Africa, Institute of Infectious Disease and Molecular Medicine, University of Cape Town, Observatory 7925, Republic of South Africa.; Tuberculosis Research Section, Laboratory of Clinical Immunology and Microbiology, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD.; Tuberculosis Imaging Program, Division of Intramural Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD., Flynn JL; Department of Microbiology and Molecular Genetics, University of Pittsburgh School of Medicine, PA 15261, United States of America., Ellner JJ; Division of Infectious Diseases, Center for Emerging Pathogens, New Jersey Medical School, Rutgers University, Newark, NJ, USA., Wilkinson RJ; Centre for Infectious Diseases Research in Africa, Institute of Infectious Disease and Molecular Medicine, University of Cape Town, Observatory 7925, Republic of South Africa.; The Francis Crick Institute London NW1 1AT, United Kingdom.; Department of Infectious Diseases, Imperial College London W12 0NN, United Kingdom.
Jazyk:	angličtina
Zdroj:	MedRxiv : the preprint server for health sciences [medRxiv] 2023 Jul 03. Date of Electronic Publication: 2023 Jul 03.
DOI:	10.1101/2023.07.03.23292111
Abstrakt:	Background: The evolution of tuberculosis (TB) disease during the clinical latency period remains incompletely understood. Methods: 250 HIV-uninfected, adult household contacts of rifampicin-resistant TB with a negative symptom screen underwent baseline 18 F-Fluorodeoxyglucose positron emission and computed tomography (PET/CT), repeated in 112 after 5-15 months. Following South African and WHO guidelines, participants did not receive preventive therapy. All participants had intensive baseline screening with spontaneous, followed by induced, sputum sampling and were then observed for an average of 4.7 years for culture-positive disease. Baseline PET/CT abnormalities were evaluated in relation to culture-positive disease. Results: At baseline, 59 (23.6%) participants had lung PET/CT findings consistent with TB of which 29 (11.6%) were defined as Subclinical TB, and 30 (12%) Subclinical TB-inactive. A further 83 (33.2%) had other lung parenchymal abnormalities and 108 (43.2%) had normal lungs. Over 1107-person years of follow-up 14 cases of culture-positive TB were diagnosed. Six cases were detected by intensive baseline screening, all would have been missed by the South African symptom-based screening strategy and only one detected by a WHO-recommended chest X-Ray screening strategy. Those with baseline Subclinical TB lesions on PET/CT were significantly more likely to be diagnosed with culture-positive TB over the study period, compared to those with normal lung parenchyma (10/29 [34.5%] vs 2/108 [1.9%], Hazard Ratio 22.37 [4.89-102.47, p<0.001]). Conclusions: These findings challenge the latent/active TB paradigm demonstrating that subclinical disease exists up to 4 years prior to microbiological detection and/or symptom onset. There are important implications for screening and management of TB.
Databáze:	MEDLINE
Externí odkaz:	Zobrazit plný text záznamu