LTBI: latent tuberculosis infection or lasting immune responses to M. tuberculosis? A TBNET consensus statement

被引：413

作者：

Mack, U. ^{[2
]}

Migliori, G. B. ^{[3
]}

Sester, M. ^{[4
]}

Rieder, H. L. ^{[5
]}

Ehlers, S.

Goletti, D. ^{[6
]}

Bossink, A. ^{[7
]}

Magdorf, K. ^{[8
]}

Hoelscher, C.

Kampmann, B. ^{[9
]}

Arend, S. M. ^{[10
]}

Detjen, A. ^{[8
]}

Bothamley, G. ^{[11
]}

Zellweger, J. P. ^{[12
]}

Milburn, H. ^{[13
]}

Diel, R. ^{[14
]}

Ravn, P. ^{[15
]}

Cobelens, F. ^{[16
]}

Cardona, P. J. ^{[17
,18
,19
]}

Kan, B. ^{[20
]}

Solovic, I. ^{[21
]}

Duarte, R. ^{[22
]}

Cirillo, D. M. ^{[23
]}

Lange, C. ^{[1
]}

机构：

[1] Res Ctr Borstel, Med Clin, Div Clin Infect Dis, D-23845 Borstel, Germany

[2] Lovisenberg Diakonale Sykehus, Oslo, Norway

[3] Fdn S Maugeri, Tradate, Italy

[4] Univ Saarland, Dept Internal Med 4, D-6650 Homburg, Germany

[5] Int Union TB & Lung Dis, Kirchlindach, Switzerland

[6] Natl Inst Infect Dis L Spallanzani, Rome, Italy

[7] Diakonessen Hosp, Utrecht, Netherlands

[8] Charite, Dept Paediat Pneumol & Immunol, Berlin, Germany

[9] Univ London Imperial Coll Sci Technol & Med, London, England

[10] Leiden Univ, Med Ctr, Leiden, Netherlands

[11] Homerton Univ Hosp, London, England

[12] Swiss Lung Assoc, Bern, Switzerland

[13] Guys & St Thomas Hosp, London SE1 9RT, England

[14] Univ Dusseldorf, Dusseldorf, Germany

[15] Herlev Univ Hosp, Herlev, Denmark

[16] KNCV, Royal Netherlands TB Assoc, The Hague, Netherlands

[17] UAB, Inst Germans Trias & Pujol, Badalona, Spain

[18] CIBER Enfermedades Resp, Palma de Mallorca, Spain

[19] Inst Carlos III, Palma de Mallorca, Spain

[20] Karolinska Hosp, S-10401 Stockholm, Sweden

[21] Inst TB Lung Dis & Thorac Surg, Vysne Hagy, Slovakia

[22] Ctr Diagnost Pneumol, Vila Nova De Gaia, Portugal

[23] Ist Sci San Raffaele, I-20132 Milan, Italy

来源：

EUROPEAN RESPIRATORY JOURNAL | 2009年 / 33卷 / 05期

基金：

美国国家卫生研究院;

关键词：

Consensus statement; interferon-gamma release assay; latent tuberculosis infection; preventive chemotherapy; tuberculin skin test; tuberculosis; ENZYME-LINKED IMMUNOSPOT; GAMMA RELEASE ASSAYS; MYCOBACTERIUM-BOVIS BCG; T-CELL RESPONSES; SKIN-TEST; ACTIVE TUBERCULOSIS; BLOOD-TESTS; IMMUNOHISTOLOGICAL ANALYSIS; ENDOGENOUS REACTIVATION; PULMONARY TUBERCULOSIS;

D O I：

10.1183/09031936.00120908

中图分类号：

R56 [呼吸系及胸部疾病];

学科分类号：

摘要：

Tuberculosis control relies on the identification and preventive treatment of individuals who are latently infected with Mycobacterium tuberculosis. However, direct identification of latent tuberculosis infection is not possible. The diagnostic tests used to identify individuals latently infected with M. tuberculosis, the in vivo tuberculin skin test and the ex vivo interferon-gamma release assays (IGRAs), are designed to identify an adaptive immune response against, but not necessarily a latent infection with, M. tuberculosis. The proportion of individuals who truly remain infected with M. tuberculosis after tuberculin skin test or IGRA conversion is unknown. It is also uncertain how long adaptive immune responses towards mycobacterial antigens persist in the absence of live mycobacteria. Clinical management and public healthcare policies for preventive chemotherapy against tuberculosis could be improved, if we were to gain a better understanding on M. tuberculosis latency and reactivation. This statement by the TBNET summarises knowledge and limitations of the currently available tests used in adults and children for the diagnosis of latent tuberculosis infection. In summary, the main issue regarding testing is to restrict it to those who are known to be at higher risk of developing tuberculosis and who are willing to accept preventive chemotherapy.

引用

页码：956 / 973

页数：18

共 152 条

[1]

Andvord K. F., 1930, Norsk Magazin for Laegevidenskaben, V91, P642

[2]

Andvord KF, 2002, INT J TUBERC LUNG D, V6, P562

[3]

[Anonymous], CLIN INFECT DIS

[4]

[Anonymous], 2006, J HOSP INFECT

[5]

[Anonymous], REINFECTIONS TUBERCU

[6] RISK-FACTORS FOR TUBERCULOSIS IN HIV-INFECTED PERSONS - A PROSPECTIVE COHORT STUDY [J].

ANTONUCCI, G ;

GIRARDI, E ;

RAVIGLIONE, MC ;

IPPOLITO, G .

JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 1995, 274 (02) :143-148

[7] Comparison of two interferon-γ assays and tuberculin skin test for tracing tuberculosis contacts [J].

Arend, Sandra M. ;

Thijsen, Steven F. T. ;

Leyten, Eliane M. S. ;

Bouwman, John J. M. ;

Franken, Willeke P. J. ;

Koster, Ben F. P. J. ;

Cobelens, Frank G. J. ;

van Houte, Arend-Jan ;

Bossink, Ailko W. J. .

AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE, 2007, 175 (06) :618-627

[8] Evidence of endogenous reactivation of tuberculosis after a long period of latency [J].

Arend, SM ;

van Dissel, JT .

JOURNAL OF INFECTIOUS DISEASES, 2002, 186 (06) :876-877

[9] Prognostic Value of a T-Cell-Based, Interferon-γ Biomarker in Children with Tuberculosis Contact [J].

Bakir, Mustafa ;

Millington, Kerry A. ;

Soysal, Ahmet ;

Deeks, Jonathan J. ;

Efee, Serpil ;

Aslan, Yasemin ;

Dosanjh, Davinder P. S. ;

Lalvani, Ajit .

ANNALS OF INTERNAL MEDICINE, 2008, 149 (11) :777-W163

[10] Purified protein derivative-activated type 1 cytokine-producing CD4+ T lymphocytes in the lung:: A characteristic feature of active pulmonary and nonpulmonary tuberculosis [J].

Barry, SM ;

Lipman, MC ;

Bannister, B ;

Johnson, MA ;

Janossy, G .

JOURNAL OF INFECTIOUS DISEASES, 2003, 187 (02) :243-250

← 1 2 3 4 5 6 7 8 9 10 →