Evaluation of the Prognostic Value of IFN-γ Release Assay and Tuberculin Skin Test in Household Contacts of Infectious Tuberculosis Cases in Senegal 英文参考文献.docVIP

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Evaluation of the Prognostic Value of IFN-γ Release Assay and Tuberculin Skin Test in Household Contacts of Infectious Tuberculosis Cases in Senegal 英文参考文献.doc

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Evaluation of the Prognostic Value of IFN-γ Release Assay and Tuberculin Skin Test in Household Contacts of Infectious Tuberculosis Cases in Senegal 英文参考文献

EvaluationofthePrognosticValueofIFN-cRelease AssayandTuberculinSkinTestinHouseholdContactsof InfectiousTuberculosisCasesinSenegal ChristianLienhardt1*,KatherineFielding2,AbdoulA.Hane3,AliouNiang3,CheikhT.Ndao1 ,Farba Karam4,HelenFletcher5,FatouMbow1,Jules-Franc?ois Gomis1,RogerDiadhiou4,MaximeToupane4, TandakhaDieye4,SouleymaneMboup4 1InstitutdeRecherchepourleDe′veloppement, ProgrammeTuberculose,Dakar,Senegal,2InfectiousDiseaseEpidemiologyUnit,LondonSchoolofHygieneTropical Medicine,London,UnitedKingdom,3ServicedePneumologie,Ho?pitalFann,Dakar,Senegal,4LaboratoiredeBacte′riologie–Virologie,Ho?pitalAristideLeDantec,Dakar, Senegal,5CentreforClinicalVaccinologyandTropicalMedicine(CCVTM),UniversityofOxford,ChurchillHospital,Oxford,UnitedKingdom Abstract Background:Chemoprophylaxisofcontactsofinfectioustuberculosis(TB)casesisrecommendedforTBcontrol,particularly inendemiccountries,butishamperedbythedifficultytodiagnoselatentTBinfection(LTBI),classicallyassessedthrough response to the Tuberculin Skin Test (TST). Interferon-gamma release assays (IGRA) are proposed new tools to diagnose LTBI, but there are limited data on their ability to predict the development of active TB disease. To address this, we investigatedtheresponsetoTSTandIGRAinhouseholdcontactsofinfectiousTBcasesinaTBhigh-burdencountryandthe potentialcorrelationwithdevelopmentofTB. Methodology/PrincipalFindings:ProspectivehouseholdcontactsstudyconductedintwohealthcentresinDakar,Senegal. Atotalof2679householdcontactsof206newlydetectedsmearand/orculturepositiveindexTBcasesaged18yearsor greaterwereidentifiedATSTwasperformedineachcontactandanESAT6/CFP10ELISPOTassayperformedinarandom sampleofthose.Contactswerefollowed-upfor24months.TBwasdiagnosedin52contacts,anincidencerateof9.27/1000 person-years. In univariable analysis, the presence of positive TST ($10mm) and ELISPOT (.32 SFC/million PBMC) responsesatbaselinewereassociatedwithactiveTBduringfollow-up:RateRatio[RR]=2.32(95%CI:1.12–4.84)andRR=2.09 (95%CI:0.83–