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latent tuberculosis:Risk factors,screening and treatment in liver transplantation recipients from an endemic area

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World Journal of Transplantation 2021年第12期11卷 512-522页

作者： Isabela Dias Lauar Luciana Costa Faria Roberta Maia de Castro Romanelli Wanessa Trindade Clemente Medicine Department Universidade Josédo Rosário VellanoBelo Horizonte 31710030Minas GeraisBrazil Internal Medicine Department Faculdade de MedicinaUniversidade Federal de Minas Gerais(UFMG)Belo Horizonte 30130100Minas GeraisBrazil Pediatrics Department Faculdade de MedicinaUniversidade Federal de Minas Gerais(UFMG)Belo Horizonte 30130100Minas GeraisBrazil Department of Laboratory Medicine Faculdade de MedicinaUniversidade Federal de Minas Gerais(UFMG)Belo Horizonte 30130100Minas GeraisBrazil

BACKGROUND Patients undergoing solid organ transplantation,particularly those who live or have lived in tuberculosis(TB)endemic areas,are at a high risk of developing TB.The majority of post-transplantation TB cases are associated with reactivation of latent TB infection(LTBI).Brazil is in a single position with overlapping areas of high TB endemicity and high transplant activity.In liver transplant(LT),one should be aware of the potential hepatotoxicity associated with the treatment regimens for LTBI.AIM To evaluate the frequency of LTBI in LT patients and treatment-related issues.METHODS This was a retrospective analysis of a cohort of cirrhotic patients aged≥18 years,who underwent LT at a high-complexity teaching hospital from January 2005 to December 2012.RESULTS Overall,429 patients underwent LT during the study period.Of these,213(49.7%)underwent the tuberculin skin test(TST)during the pre-transplant period,and 35(16.4%)of them had a positive result.The treatment for LTBI was initiated after LT in 12(34.3%)of the TST-positive patients;in 3(25.0%),treatment was maintained for at least 6 mo.CONCLUSION The prevalence of LTBI was lower than expected.Initiation and completion of LTBI treatment was limited by difficulties in the management of these special patients.

关键词： latent tuberculosis Liver transplantation tuberculosis Infection Transplantation Risk factors

Ustekinumab Treatment in Patients with Moderate-to-Severe Psoriasis and latent tuberculosis Infection: A Study of 3 Case Reports

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Journal of Cosmetics, Dermatological Sciences and Applications 2022年第2期12卷 95-99页

作者： Waqas S. Abdulwahhab Alaa S. Mehair Al Shayma F. Iedi Department of Dermatology and Venereology Al Qassimi Hospital Sharjah United Arab Emirates College of Medicine Sharjah University Sharjah United Arab Emirates

Background: Ustekinumab is a human monoclonal antibody that binds to the shared P40 subunit of interleukin (IL)-12 and IL-23 and is approved for the treatment of moderate-to-severe psoriasis. latent tuberculosis (LTBI) was diagnosed based on a positive tuberculin skin test (TST) or QuantiFERON-TB test without evidence of active tuberculosis (TB). Aim: To evaluate the risk of active tuberculosis reinfection in patients with a history of psoriasis and LTBI after INH prophylaxis treated with Ustekinumab. Case Report: We are describing 3 patients with a history of moderate-to-severe plaque psoriasis and newly identified LTBI who have been treated with INH monotherapy before starting Ustekinumab therapy followed-up over 2 years for any sign of tuberculosis reinfection. Conclusion: Ustekinumab is an option for treating psoriasis and LTBI with minimal risk of reactivation after INH prophylaxis.

关键词： Psoriasis Ustekinumab latent tuberculosis QuantiFERON-TB Test

Chronic Spontaneous Urticaria on Omalizumab Therapy and latent tuberculosis Infection: A New Case Report

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Journal of Cosmetics, Dermatological Sciences and Applications 2023年第1期13卷 33-37页

作者： Waqas S. Abdulwahhab Fatima M. Al Qaydi Department of Dermatology and Venereology Al Qassimi Hospital Sharjah UAE College of Medicine Sharjah University Sharjah UAE Dubai Health Authority Dubai UAE

Background: Chronic Spontaneous urticarial (CSU) is a common dermatological problem characterized by recurrent pruritic or burning wheals last less than 24 hours and treated by many modalities of therapy including systemic antihistamines and in refractory cases with Omalizumab anti-IgE antibody biological injection. latent tuberculosis infection (LTBI) is diagnosed based on a positive tuberculin skin test or QuantiFERON-TB test without evidence of active tuberculosis. Aim: To document a new case report of a patient with a history of CSU and latent tuberculosis on Omalizumab therapy during Isoniazid (INH) prophylaxis. Case Report: A-53-year-old woman with a history of CSU and newly identified LTBI who have been treated with INH monotherapy before starting Omalizumab injection followed up over 24 weeks course of therapy for any sign of tuberculosis reinfection. Conclusion: Omalizumab injection was used effectively for the treatment of CSU in a patient with latent tuberculosis infection with minimal risk of tuberculosis reactivation.

关键词： Chronic Spontaneous Urticaria latent tuberculosis Omalizumab QuantiFERON-TB Test

Evaluation of Interferon-Gamma Release Assay Testing and Tuberculin Skin Test for Early Diagnosis of tuberculosis in Children and Adolescents

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Open Journal of Pediatrics 2024年第3期14卷 558-567页

作者： Yelda Sorguç Miray Çelebi Yılmaz Yüce Ayhan Yakup Yaman Şener Tulumoğlu Aybüke Akaslan Kara İlker Devrim University of Health Sciences Dr. Beh&#231et Uz Child Disease and Pediatric Surgery Training and Research Hospital Medical Microbiology &#304zmir T&#252rkiye Department of Pediatric Infectious Diseases University of Health Sciences Dr. Beh&#231et Uz Child Disease and Pediatric Surgery Training and Research Hospital &#304zmir T&#252rkiye

Background: This study aimed to evaluate the diagnostic value of interferon-γ release assay (IGRA), a sensitive microbiological diagnostic method, in children and adolescents with suspected tuberculosis in a country with a high burden of tuberculosis. Method: This study included 581 children and adolescents aged 4 - 19 years who were suspected of having tuberculosis, were latently infected with Mycobacterium tuberculosis, and had received at least one dose of BCG vaccine between April 17, 2019, and February 24, 2021. The study evaluated the TST results of 106 patients who had a positive Quantiferon test and were suspected of having tuberculosis. Results: The study included 581 patients aged between 4 and 19 years. Of these, 106 patients tested positive for the Quantiferon test, while 19 were indeterminate and 456 were negative. The Quantiferon test positivity rate was 18.24%. Among the 106 QFT-Plus-positive cases, 23 patients also tested positive for TST. The difference in distribution was found to be statistically significant. Conclusion: The QFT-Plus test is considered an alternative to TST and other microbiological diagnostic methods for early tuberculosis diagnosis, particularly in children and adolescents.

关键词： Interferon Gamma Release Assay Children Tuberculin Test Children latent tuberculosis

Completion of 6-mo isoniazid preventive treatment among eligible under six children:A cross-sectional study,Lagos,Nigeria

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World Journal of Clinical Cases 2023年第1期11卷 104-115页

作者： Victor Abiola Adepoju Ademola Adelekan Aderonke Agbaje Femi Quaitey Tobi Ademola-Kay Ann Uduak Udoekpo Olusola Daniel Sokoya Department of HIV and Infectious Diseases Jhpiego NigeriaFederal Capital TerritoryAbuja 900918Nigeria Department of Research Bluegate Research InstituteIbadan 211271Oyo StateNigeria Clinical Services Institute of Human Virology of NigeriaAbuja 900918Nigeria Department of HIV and Infectious Diseases Jhpiego NigeriaUyo 520108AkwaIbomNigeria Adolescent and Youth Care Youth Development and Empowerment InitiativeLagos 23401Nigeria Monitoring and Evaluation Jhpiego NigeriaUyo 520108AkwaIbomNigeria Lagos State tuberculosis Buruli Ulcer and Leprosy Control ProgramIkeja 100001LagosNigeria

BACKGROUND Nigeria is one of the thirty high burden countries with significant contribution to the global childhood tuberculosis epidemic.tuberculosis annual risk for children could be as high as 4%particularly in high tuberculosis(TB)prevalent communities.Isoniazid(INH)Preventive Therapy has been shown to prevent TB incidence but data on its implementation among children are scarce.AIM To determine the completion of INH among under six children that were exposed to adults with smear positive pulmonary TB in Lagos,Nigeria.METHODS This was a hospital-based retrospective cross-sectional review of 265 medical records of eligible children0.005).CONCLUSION This study demonstrated suboptimal INH completion rate among children with only 6 out of 10 children initiated on INH who completed a 6-mo treatment in Lagos,Nigeria.The huge drop-offs in the first 2 mo of INH calls for innovative strategies such as the use of 60-d INH calendar that would facilitate reminder and early eng

关键词： Isoniazid Child tuberculosis Treatment Outcome Completion latent tuberculosis Dosage

Implementation of ison iazid preventive therapy in southern Lima, Peru: an analysis of health center characteristics

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Infectious Diseases of Poverty 2021年第3期10卷 26-33页

作者： Roberto Zegarra-Chaponan Lily Victoria Bonadonna Courtney M.Yuen Martha Brigida Martina-Chavez Jhon Zeladita-Huaman Universidad Maria Auxiliadora LimaPeru Wayne State University School of Medicine DetroitMlUSA Harvard Medical School BostonMAUSA. Universidad Nacional Mayor de San Marcos LimaPeru.

Background:tuberculosis(TB)prevention through the use of preventive treatment is a critical activity in the elimination ofTB.In multiple settings,limited staffing has been identified as a barrier to managing preventive treatment for TB contacts.This study aims to determine how health center staffing,service type,and TB caseload affects implementation of isoniazid preventive therapy(IPT)forTB contacts in southern Lima.Methods:We conducted an ecological study in 2019 in southern Lima,Peru.Through the review of medical records,we identified contacts ofTB patients who initiated IPT during 2016-2018,and who were 0-19 years old,the age group eligible for IPT according to Peruvian guidelines.We assessed bivariate associations between health center characteristics(numbers of physicians and nurses,types of services available,annual TB caseload)and IPT initiation and completion using binomial logistic regression.Results:Among 977 contacts,69%took more than a week to start IPT and 41%did not complete IPT.For those who successfully completed IPT,58%did not complete full medical follow-up.There was no significant difference in IPT completion or adherence based on whether health centers had more physicians and nurses,more comprehensive services,or higherTB caseloads.Among contacts,female sex was associated with delay in initiating IPT(P=0.005),age 5-19 years old was associated with completion of IPT(P=0.025)and age<5 years old was associated with completion of clinical evaluations(P=0.041).Conclusions:There are significant gaps in IPT implementation in health centers of southern Lima,Peru,but insufficient staffing of health centers may not be responsible.Further research is needed to identify how IPT implementation can be improved,potentially through improving stafftraining or monitoring and supervision.

关键词： Contacts Chemotherapy latent tuberculosis Children Adolescent

Active tuberculosis in inflammatory bowel disease patients under treatment from an endemic area in Latin America

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World Journal of Gastroenterology 2020年第44期26卷 6993-7004页

作者： Flora Maria Lorenzo Fortes Ney Boa Sorte Victor D Mariano Laila D Andrade Fernanda A Oliveira Monique CA Santos Claudia Ivanilda N dos Santos Catharina A Passos Mila P Pacheco Valdiana C Surlo Neogelia P de Almeida Jaciane AM Fontes Andrea M Pimentel Raquel Rocha Genoile Oliveira Santana Pharmaceutical Sciences Pos-graduation Program State University of BahiaSalvadorBA 40460-120Brazil Outpatient Gastroenterology Unit General Hospital Roberto SantosSalvadorBA 40286-901Brazil Life Sciences Department State University of BahiaSalvadorBA 41150-000Brazil Department of Medicine FTC UniversitySalvadorBA 41741-590Brazil Department of Sciences of Nutrition School of NutritionFederal University of BahiaSalvadorBA 41701-035Brazil

BACKGROUND There has been an increase in cases of inflammatory bowel disease(IBD)in recent years.There is also greater access and availability of immunosuppressive and biological agents,which increase the risk of opportunistic infection despite improving the quality of life and promoting mucosal healing.tuberculosis(TB)remains a public health problem,and it has a high incidence in several countries.Therefore,knowledge of the risk of developing TB in patients with IBD is important.AIM To evaluate the risk of active TB in patients with IBD under treatment from an endemic area in Latin America.METHODS A standard questionnaire included demographic variables,clinical aspects of IBD disease,history of active TB during treatment,active TB characteristics and evolution,initial screening and results and time from the start of anti-tumor necrosis factor alpha(TNFα)to TB development.RESULTS Azathioprine,anti-TNFα and the combination of these two drugs were associated with a higher risk of active TB incidence.The TNFα blockers increased the relative risk of developing active TB compared to other treatments.All four multivariable models showed that the use of TNFα blockers alone or in combination with azathioprine was an important risk factor for the incidence of active TB.After adjustment for sex,age,type of IBD and latent TB,anti-TNFα with azathioprine increased the relative risk to 17.8 times more than conventional treatment.Late TB,which was diagnosed 3 mo after the start of anti-TNFα,was the most frequent.CONCLUSION Treatment with anti-TNFα increased the risk of active TB in IBD patients from an endemic area in Latin America.This risk was increased when anti-TNFα was combined with azathioprine.The time from the beginning of the treatment to the active TB diagnosis suggests a new TB infection.

关键词： Inflammatory bowel disease Therapy Tumor necrosis factor alpha Relative risk tuberculosis latent tuberculosis

Characterization of and advanced diagnostic methods for ocular tuberculosis and tuberculosis

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International Journal of Ophthalmology(English edition) 2020年第11期13卷 1820-1826页

作者： Wei-Jia Yan Hai-Yan Zhou Hong Yan Xi'an People's Hospital(Xi'an Fourth Hospital) Affiliated Northwestern Polytechnical UniversityShaanxi Eye HospitalXi’an 710004Shaanxi ProvinceChina Department of Infection Immunity&Cardiovascular DiseaseUniversity of SheffieldMedical SchoolSheffield S1O 2RXUK Department of Ophthalmology Shaanxi Provincial People’s HospitalXi’an 710068Shaanxi ProvinceChina

tuberculosis(TB)is an airborne infection caused by Mycobacterium tuberculosis that usually affects the lungs.Timely treatment of active TB,diagnosis and prevention of latent TB are very important.However,extrapulmonary TB affects almost any tissues around the eye and orbit,and it then requires a high degree of suspicion to accurately diagnose.Diagnostic delays are common and may lead to morbidity.For ophthalmologists and infectious disease specialists,it is important to work together to accurately diagnose and treat ocular tuberculosis(OTB)to prevent vision loss.This review reports the latest advanced diagnostic methods for active TB and latent TB as well as various known manifestations of 0TB.Important elements of diagnosis and treatment are also reviewed.

关键词： latent tuberculosis ocular tuberculosis diagnosis