Progression to active tuberculosis, but not transmission, varies by Mycobacterium tuberculosis lineage in The Gambia.
Progression to active tuberculosis, but not transmission, varies by Mycobacterium tuberculosis lineage in The Gambia.
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DOI：
10.1086/591504
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发表时间：
2008-10-01
影响因子：
6.4
通讯作者：
Adegbola, Richard A.
中科院分区：
文献类型：
--
作者：
de Jong, Bouke C.;Hill, Philip C.;Aiken, Alex;Awine, Timothy;Antonio, Martin;Adetifa, Ifedayo M.;Jackson-Sillah, Dolly J.;Fox, Annette;DeRiemer, Kathryn;Gagneux, Sebastien;Borgdorff, Martien W.;McAdam, Keith P. W. J.;Corrah, Tumani;Small, Peter M.;Adegbola, Richard A.
M的结果存在相当大的变异性。肺结核感染。我们假设M。africanum比M.结核病传播并发展为结核病。在一项对冈比亚结核病患者及其家庭接触者的队列研究中，我们根据对M.结核或M.非洲的。阳性皮肤试验表明在2年随访期间结核病的传播和发展表明疾病进展。传播是相似的，但疾病进展明显低于接触M。africanum比M.结核病（1.0% vs 2.9%;风险比（HR）3.1，95% CI 1.1-8.7）。在M.严格意义上的结核病，接触北京家族菌株的人最有可能进展为疾病（5.6%; HR 6.7（2.0-22）相对于M. africanum）。M. africanum和M.结核病在家庭接触者中传播同样良好，但接触M.非洲人比暴露于M.结核不同谱系的进展率表明，结核病的变异性在临床环境中很重要，在评估结核病疫苗和潜伏性结核病感染治疗方案的研究中应考虑到这一点。
Considerable variability exists in the outcome of M. tuberculosis infection. We hypothesized that M. africanum was less likely than M. tuberculosis to transmit and progress to tuberculosis disease. In a cohort study of tuberculosis patients and their household contacts in the Gambia, we categorized 1,808 HIV negative tuberculosis contacts according to exposure to M. tuberculosis or to M. africanum. A positive skin test indicated transmission and development of tuberculosis during 2 years of follow-up indicated progression to disease. Transmission was similar, but progression to disease was significantly lower in contacts exposed to M. africanum than to M. tuberculosis (1.0% vs 2.9%; Hazard Ratio (HR) 3.1, 95% CI 1.1–8.7). Within M. tuberculosis sensu stricto, contacts exposed to a Beijing family strain were most likely to progress to disease (5.6%; HR 6.7 (2.0–22) relative to M. africanum). M. africanum and M. tuberculosis transmit equally well to household contacts, but contacts exposed to M. africanum are less likely to progress to tuberculosis disease than those exposed to M. tuberculosis. The variable rate of progression by lineage suggests that TB variability matters in clinical settings and should be taken into account in studies evaluating tuberculosis vaccines and treatment regimens for latent tuberculosis infection.
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影响因子：
2.4
作者：
ANDERSON, RM;MAY, RM
通讯作者：
MAY, RM
影响因子：
9.4
作者：
Kamerbeek, J;Schouls, L;vanEmbden, J
通讯作者：
vanEmbden, J
影响因子：
6.4
作者：
de Jong, BC;Hill, PC;Adegbola, RA
通讯作者：
Adegbola, RA
影响因子：
3.2
作者：
Grange, JM
通讯作者：
Grange, JM
影响因子：
3.7
作者：
Hill, Philip C.;Jeffries, David J.;McAdam, Keith P.
通讯作者：
McAdam, Keith P.