IFNgamma response to Mycobacterium tuberculosis, risk of infection and disease in household contacts of tuberculosis patients in Colombia.
IFNgamma response to Mycobacterium tuberculosis, risk of infection and disease in household contacts of tuberculosis patients in Colombia.
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DOI：
10.1371/journal.pone.0008257
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发表时间：
2009-12-14
期刊：
影响因子：
3.7
通讯作者：
García LF
中科院分区：
文献类型：
--
作者：
del Corral H;París SC;Marín ND;Marín DM;López L;Henao HM;Martínez T;Villa L;Barrera LF;Ortiz BL;Ramírez ME;Montes CJ;Oquendo MC;Arango LM;Riaño F;Aguirre C;Bustamante A;Belisle JT;Dobos K;Mejía GI;Giraldo MR;Brennan PJ;Robledo J;Arbeláez MP;Rojas CA;García LF
肺结核患者的家庭接触者是结核分枝杆菌感染和早期疾病发展的高危人群。确定有结核病风险的个人是结核病控制的理想目标。使用特定结核分枝杆菌抗原的干扰素-伽马释放试验(IGRAs)为检测感染提供了一种替代结核菌素皮肤试验(TST)的方法。此外，对这些抗原反应产生的干扰素γ水平可能对预后有价值。我们估计了HHC及其来源人群(SP)中结核分枝杆菌IGRA和TST感染的流行率，并评估了HHC中干扰素γ水平是否与结核病的发生有关。在接触结核病病例后，对2060名HHC队列进行了2-3年的跟踪调查。除了TST，干扰素γ对分枝杆菌抗原：CFP、CFP-10、Hspx和Ag85A的反应在7天的全血培养中进行了评估，并与哥伦比亚麦德林SP的766人进行了比较。没有向接触过儿童的人提供异烟肼预防，因为哥伦比亚的结核病法规认为它只适用于5岁以下的儿童，没有接种卡介苗就呈TST阳性。TST法阳性率为65.9%，SP阳性率为42.7%(OR2.60，p<；0.0001)。干扰素γ对结核分枝杆菌感染的生物标志物CFP-10的反应在66.3%的HHC和24.3%的SP中检测为阳性(OR = 6.07，p<；0.0001)。结核病发病率为7.0/1000人年。5岁以下儿童占发病总数的21.6%。干扰素γ阳性组与阴性组之间差异无统计学意义(HR 1.82 95%CI 0.79~4.20p = 0.16)。然而，在高HHC干扰素γ产生者中观察到结核病发展的显著趋势(趋势日志排名p = 0.007)。CFP-10诱导的干扰素γ的产生有助于确定HHC中结核病感染的流行率，并识别那些疾病风险最高的人。儿童中的高结核病发病率支持对接触儿童的人进行化疗，而不考虑接种卡介苗。
Household contacts (HHCs) of pulmonary tuberculosis patients are at high risk of Mycobacterium tuberculosis infection and early disease development. Identification of individuals at risk of tuberculosis disease is a desirable goal for tuberculosis control. Interferon-gamma release assays (IGRAs) using specific M. tuberculosis antigens provide an alternative to tuberculin skin testing (TST) for infection detection. Additionally, the levels of IFNγ produced in response to these antigens may have prognostic value. We estimated the prevalence of M. tuberculosis infection by IGRA and TST in HHCs and their source population (SP), and assessed whether IFNγ levels in HHCs correlate with tuberculosis development. A cohort of 2060 HHCs was followed for 2–3 years after exposure to a tuberculosis case. Besides TST, IFNγ responses to mycobacterial antigens: CFP, CFP-10, HspX and Ag85A were assessed in 7-days whole blood cultures and compared to 766 individuals from the SP in Medellín, Colombia. Isoniazid prophylaxis was not offered to child contacts because Colombian tuberculosis regulations consider it only in children under 5 years, TST positive without BCG vaccination. Using TST 65.9% of HHCs and 42.7% subjects from the SP were positive (OR 2.60, p<0.0001). IFNγ response to CFP-10, a biomarker of M. tuberculosis infection, tested positive in 66.3% HHCs and 24.3% from the SP (OR = 6.07, p<0.0001). Tuberculosis incidence rate was 7.0/1000 person years. Children <5 years accounted for 21.6% of incident cases. No significant difference was found between positive and negative IFNγ responders to CFP-10 (HR 1.82 95% CI 0.79–4.20 p = 0.16). However, a significant trend for tuberculosis development amongst high HHC IFNγ producers was observed (trend Log rank p = 0.007). CFP-10-induced IFNγ production is useful to establish tuberculosis infection prevalence amongst HHC and identify those at highest risk of disease. The high tuberculosis incidence amongst children supports administration of chemoprohylaxis to child contacts regardless of BCG vaccination.
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对结核分枝杆菌感染的ELISPOT测试的纵向评估。
影响因子：
15.8
作者：
Hill, Philip C.;Brookes, Roger H.;Fox, Annette;Jackson-Sillah, Dolly;Jeffries, David J.;Lugos, Moses D.;Donkor, Simon A.;Adetifa, Ifedayo M.;de Jong, Bouke C.;Aiken, Alex M.;Adegbola, Richard A.;McAdam, Keith P.
通讯作者：
McAdam, Keith P.
DOI：
10.1128/cdli.10.4.602-611.2003
发表时间：
2003-07-01
期刊：
CLINICAL AND DIAGNOSTIC LABORATORY IMMUNOLOGY
影响因子：
--
作者：
Black, GF;Weir, RE;Dockrel, HM
通讯作者：
Dockrel, HM
影响因子：
9.4
作者：
Doherty, TM;Demissie, A;Andersen, P
通讯作者：
Andersen, P
影响因子：
168.9
作者：
Ewer, K;Deeks, J;Lalvani, A
通讯作者：
Lalvani, A
影响因子：
9.4
作者：
Dillon, DC;Alderson, MR;Houghton, R
通讯作者：
Houghton, R