Latent Tuberculosis Infection - Diagnosis and Treatment.
Latent Tuberculosis Infection - Diagnosis and Treatment.
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DOI：
10.3889/oamjms.2018.161
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发表时间：
2018-04-15
影响因子：
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通讯作者：
Trajkov D
中科院分区：
文献类型：
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作者：
Ilievska-Poposka B;Metodieva M;Zakoska M;Vragoterova C;Trajkov D
潜伏性结核感染（LTBI）被定义为对结核分枝杆菌抗原刺激的持续免疫反应状态，但没有临床表现的活动性结核病（TB）证据。 LTBI 的诊断和治疗对于结核病非常重要，尤其是在高危人群中。结核菌素皮试 (TST) 和干扰素γ释放试验 (IGRA) 用于诊断 LTBI。该研究旨在展示 IGRA 测试与 TST 在 LTBI 筛查中的首次结果比较以及马其顿 LTBI 病例的治疗结果。本研究纳入了 2016 年诊断和治疗的 73 例 LTBI 病例。为了诊断 LTBI，我们使用了 TST RT -23 5T.U。以及商业 IGRA 测试，例如 QuantiFERON-TB Gold In-Tube (QFT-IT)。 73例LTBI病例中，男性占61.64%，女性占38.36%。在所有年龄组中，最常见的是5岁至14岁之间的病例（54.79%）。在评估的 LTBI 危险人群中，最常见的是肺结核病例的家庭接触儿童（61-83.65%），其次是 HIV 感染者（9-12.33%），只有 3 例有其他医疗原因。 TST阳性34例（46.57%），IGRA检测阳性25例（34.25%）。关于治疗方案，我们采用两种方案：50例（68.44%）接受异烟肼每日6个月疗程，23例（31.51%）接受异烟肼和利福平每日3个月疗程。治疗结果显示，大多数患者完成了治疗方案：55 例（75.34%），只有 10 例（13.09%）中断治疗。尽管过去几年取得了进展，但为了更好地管理 LTBI，仍需解决一些挑战，这将有助于加强该国的结核病控制。
Latent tuberculosis infection (LTBI) is defined as a state of persistent immune response to stimulation by Mycobacterium tuberculosis antigens without evidence of clinically manifested active tuberculosis (TB). Diagnosis and treatment for LTBI are important for TB, especially in high-risk populations. Tuberculin skin test (TST) and interferon-gamma release assays (IGRAs) are used to diagnose LTBI. The study aims to present the first results with IGRA test compared with TST in the screening of LTBI and the treatment results in the cases with LTBI in Macedonia. In this study 73 cases diagnosed and treated with LTBI in 2016 were included. For diagnosis of LTBI, we used TST RT -23 5T.U. and commercial IGRA test such as QuantiFERON-TB Gold In-Tube (QFT-IT). Out of 73 cases with LTBI, 61.64% were men, and 38.36% were women. Among all age groups, the most frequent were cases between 5 and 14 years old (54.79%). Among the evaluated risk groups for LTBI, the most frequent were children household contacts with pulmonary TB cases (61-83.65%), followed by people living with HIV (9-12.33%) and only 3 cases with other medical reasons. Positive TST had 34 cases (46.57%) and positive IGRA test 25 cases (34.25%). Regarding the treatment regimes, we use two regimes: 50 cases (68.44%) received 6 months daily regime with Isoniazid, and 23 cases (31.51%) received 3 months daily regime with Isoniazid and Rifampicin. Treatment outcomes showed that the most patients completed treatment regimes: 55 (75.34%) and only 10 (13.09%) interrupted the treatment. Despite the progress made in the last few years, several challenges remain to be addressed for better management of LTBI which will contribute to strength TB control in the country.