The ongoing challenge of latent tuberculosis.
The ongoing challenge of latent tuberculosis.
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DOI：
10.1098/rstb.2013.0437
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发表时间：
2014
期刊：
影响因子：
--
通讯作者：
Wilkinson RJ
中科院分区：
文献类型：
--
作者：
Esmail H;Barry CE 3rd;Young DB;Wilkinson RJ
全球卫生界已为自己确定了到2050年消除结核病这一公共卫生问题的任务。尽管全球结核病控制取得了进展，但目前发病率每年下降2%远未达到实现这一目标所需的速度。如果我们要在这一努力中取得成功，减少潜伏感染者（由此产生新病例）的新战略将是有利的。然而，对这一群体的程度和构成的风险的确定工作很差。目前的诊断试验（结核菌素皮肤试验和干扰素-γ释放试验）很难预测谁会发展为活动性疾病，现有的治疗选择对于可能需要的干预规模来说不是最佳的。在这篇文章中，我们概述了我们目前对潜伏性结核病的理解的基础，并强调了导致新型诊断测试，药物治疗方案和疫苗开发的创新可能有助于进展的领域。我们认为，高风险进展的个人可能比23.3亿被认为是由结核分枝杆菌免疫致敏的人要少得多，识别和靶向这一群体将是消除结核分枝杆菌的重要策略。
The global health community has set itself the task of eliminating tuberculosis (TB) as a public health problem by 2050. Although progress has been made in global TB control, the current decline in incidence of 2% yr−1 is far from the rate needed to achieve this. If we are to succeed in this endeavour, new strategies to reduce the reservoir of latently infected persons (from which new cases arise) would be advantageous. However, ascertainment of the extent and risk posed by this group is poor. The current diagnostics tests (tuberculin skin test and interferon-gamma release assays) poorly predict who will develop active disease and the therapeutic options available are not optimal for the scale of the intervention that may be required. In this article, we outline a basis for our current understanding of latent TB and highlight areas where innovation leading to development of novel diagnostic tests, drug regimens and vaccines may assist progress. We argue that the pool of individuals at high risk of progression may be significantly smaller than the 2.33 billion thought to be immune sensitized by Mycobacterium tuberculosis and that identifying and targeting this group will be an important strategy in the road to elimination.
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影响因子：
3.7
作者：
Aggerbeck, Henrik;Giemza, Rafaela;Lewis, David J. M.
通讯作者：
Lewis, David J. M.
影响因子：
64.8
作者：
通讯作者：
--
影响因子：
6.4
作者：
Brooks-Pollock, Ellen;Becerra, Mercedes C.;Murray, Megan B.
通讯作者：
Murray, Megan B.
影响因子：
9.6
作者：
Diel, Roland;Loddenkemper, Robert;Nienhaus, Albert
通讯作者：
Nienhaus, Albert
结核分枝杆菌走出非洲的迁徙以及新石器时代与现代人类的共同扩张。
影响因子：
30.8
作者：
Comas, Inaki;Coscolla, Mireia;Luo, Tao;Borrell, Sonia;Holt, Kathryn E.;Kato-Maeda, Midori;Parkhill, Julian;Malla, Bijaya;Berg, Stefan;Thwaites, Guy;Yeboah-Manu, Dorothy;Bothamley, Graham;Mei, Jian;Wei, Lanhai;Bentley, Stephen;Harris, Simon R.;Niemann, Stefan;Diel, Roland;Aseffa, Abraham;Gao, Qian;Young, Douglas;Gagneux, Sebastien
通讯作者：
Gagneux, Sebastien