Time Since Infection and Risks of Future Disease for Individuals with Mycobacterium tuberculosis Infection in the United States
| Autor: | Nicolas A Menzies, Joshua A. Salomon, Andrew N. Hill, Christian Testa, Yelena Malyuta, Suzanne M. Marks, Ted Cohen, Nicole A Swartwood |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
Adult
Risk Younger age Tuberculosis Epidemiology Population Disease 01 natural sciences Mycobacterium tuberculosis 010104 statistics & probability 03 medical and health sciences 0302 clinical medicine Latent Tuberculosis Incidence trends Medicine Humans 030212 general & internal medicine 0101 mathematics education Probability education.field_of_study biology business.industry Latent TB infection Incidence biology.organism_classification Clinical disease medicine.disease United States Natural history Infectious Diseases ComputingMethodologies_DOCUMENTANDTEXTPROCESSING Mathematical modeling business Demography |
| Zdroj: | Epidemiology (Cambridge, Mass.) |
| ISSN: | 1531-5487 |
| Popis: | Supplemental Digital Content is available in the text. Background: Risk of tuberculosis (TB) declines over time since Mycobacterium tuberculosis infection, but progression to clinical disease is still possible decades later. In the United States, most TB cases result from the progression of latent TB infection acquired over 2 years ago. Methods: We synthesized evidence on TB natural history and incidence trends using a transmission-dynamic model. For the 2020 US population, we estimated average time since infection and annual, cumulative, and remaining lifetime risks of progression to TB, by nativity and age. Results: For a newly infected adult with no other risk factors for progression to TB, estimated rates of progression declined from 38 (95% uncertainty interval: 33, 46) to 0.38 (0.32, 0.45) per 1000 person–years between the first and 25th year since infection. Cumulative risk over 25 years from new infection was 7.9% (7.0, 8.9). In 2020, an estimated average age of individuals with prevalent infection was 62 (61, 63) for the US-born population, 55 (54, 55) for non-US-born, and 57 (56, 58) overall. Average risks of developing TB over the remaining lifetime were 1.2% (1.0, 1.4) for US-born, 2.2% (1.8, 2.6) for non-US-born, and 1.9% (1.6, 2.2) for the general population. Risk estimates were higher for younger age groups. Conclusions: Our analysis suggests that, although newly infected individuals face appreciable lifetime TB risks, most US individuals with latent TB infection were infected long ago, and face low future risks of developing TB. Better approaches are needed for identifying recently infected individuals and those with elevated progression risks. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|