Risk factors for latent tuberculosis infection in close contacts of active tuberculosis patients in South Korea: a prospective cohort study

Seung Jun Lee, Seung Hun Lee, You Eun Kim, Yu Ji Cho, Yi Yeong Jeong, Ho Cheol Kim, Jong Deog Lee, Jang Rak Kim, Young Sil Hwang, Hee Jin Kim, Dick Menzies, Seung Jun Lee, Seung Hun Lee, You Eun Kim, Yu Ji Cho, Yi Yeong Jeong, Ho Cheol Kim, Jong Deog Lee, Jang Rak Kim, Young Sil Hwang, Hee Jin Kim, Dick Menzies

Abstract

Background: The diagnosis and treatment of latent tuberculosis infection (LTBI) have become mandatory to reduce the burden of tuberculosis worldwide. Close contacts of active TB patients are at high risk of both active and LTBI. The aim of this study is to identify the predominant risk factors of contracting LTBI, persons in close contact with TB patients were recruited. This study also aimed to compare the efficacy of the tuberculin skin test (TST) and QuantiFERON(®)-TB GOLD (QFT-G) to diagnose LTBI.

Methods: Close contacts of active pulmonary TB patients visiting a hospital in South Korea were diagnosed for LTBI using TST and/or QFT-G. The association of positive TST and/or QFT-G with the following factors was estimated: age, gender, history of Bacillius Calmette-Guerin (BCG) vaccination, history of pulmonary TB, cohabitation status, the acid-fast bacilli smear status, and presence of cough in source cases.

Results: Of 308 subjects, 38.0% (116/305) were TST positive and 28.6% (59/206) were QFT-G positive. TST positivity was significantly associated with male gender (OR: 1.734; 95% CI: 1.001-3.003, p =0.049), history of pulmonary TB (OR: 4.130; 95% CI: 1.441-11.835, p =0.008) and household contact (OR: 2.130; 95% CI: 1.198-3.786, p =0.01) after adjustment for confounding variables. The degree of concordance between TST and QFT-G was fair (70.4%, κ =0.392).

Conclusions: A prevalence of LTBI among close contacts of active pulmonary TB patients was high, and prior TB history and being a household contact were risk factors of LTBI in the study population.

Trial registration: ClinicalTrials.gov NCT00170209.

References

    1. WHO: Global tuberculosis report. 2013. ., []
    1. The global plan to stop TB, 2006-2015: summary.Wkly Epidemiol Rec 2006, 81(9):86-88.,
    1. Global tuberculosis control: key findings from the December 2009 WHO report. Wkly Epidemiol Rec 2010, 85(9):69-80.
    1. Mazurek GH, Jereb J, Vernon A, LoBue P, Goldberg S, Castro K. Updated guidelines for using interferon gamma release assays to detect mycobacterium tuberculosis infection - United States, 2010. MMWR. 2010;59(RR-5):1–25.
    1. Moon H, Lee J. Korean Guidelines for Tuberculosis. Korea: Joint Committee for the Development of Korean Guidelines for Tuberculosis; 2011.
    1. Mazurek GH, LoBue PA, Daley CL, Bernardo J, Lardizabal AA, Bishai WR, Iademarco MF, Rothel JS. Comparison of a whole-blood interferon gamma assay with tuberculin skin testing for detecting latent mycobacterium tuberculosis infection. JAMA. 2001;286(14):1740–1747. doi: 10.1001/jama.286.14.1740.
    1. Moran-Mendoza O, Marion SA, Elwood K, Patrick D, FitzGerald JM. Risk factors for developing tuberculosis: a 12-year follow-up of contacts of tuberculosis cases. Int J Tuberc Lung Dis. 2010;14(9):1112–1119.
    1. El-Sadr WM, Tsiouris SJ. HIV-associated tuberculosis: diagnostic and treatment challenges. Semin Respir Crit Care Med. 2008;29(5):525–531. doi: 10.1055/s-0028-1085703.
    1. Brock I, Weldingh K, Lillebaek T, Follmann F, Andersen P. Comparison of tuberculin skin test and new specific blood test in tuberculosis contacts. Am J Respir Crit Care Med. 2004;170(1):65–69. doi: 10.1164/rccm.200402-232OC.
    1. Mori T, Sakatani M, Yamagishi F, Takashima T, Kawabe Y, Nagao K, Shigeto E, Harada N, Mitarai S, Okada M, Suzuki K, Inoue Y, Tsuyuguchi K, Sasaki Y, Mazurek GH, Tsuyuguchi I. Specific detection of tuberculosis infection: an interferon-gamma-based assay using new antigens. Am J Respir Crit Care Med. 2004;170(1):59–64. doi: 10.1164/rccm.200402-179OC.
    1. Horsburgh CR, Jr, Rubin EJ. Clinical practice. Latent tuberculosis infection in the United States. N Engl J Med. 2011;364(15):1441–1448. doi: 10.1056/NEJMcp1005750.
    1. Marks SM, Taylor Z, Qualls NL, Shrestha-Kuwahara RJ, Wilce MA, Nguyen CH. Outcomes of contact investigations of infectious tuberculosis patients. Am J Respir Crit Care Med. 2000;162(6):2033–2038. doi: 10.1164/ajrccm.162.6.2004022.
    1. Morrison J, Pai M, Hopewell PC. Tuberculosis and latent tuberculosis infection in close contacts of people with pulmonary tuberculosis in low-income and middle-income countries: a systematic review and meta-analysis. Lancet Infect Dis. 2008;8(6):359–368. doi: 10.1016/S1473-3099(08)70071-9.
    1. Diel R, Loddenkemper R, Meywald-Walter K, Gottschalk R, Nienhaus A. Comparative performance of tuberculin skin test, QuantiFERON-TB-gold in tube assay, and T-Spot.TB test in contact investigations for tuberculosis. Chest. 2009;135(4):1010–1018. doi: 10.1378/chest.08-2048.
    1. Huang YW, Shen GH, Lee JJ, Yang WT. Latent tuberculosis infection among close contacts of multidrug-resistant tuberculosis patients in central Taiwan. Int J Tuberc Lung Dis. 2010;14(11):1430–1435.
    1. Jo KW, Hong Y, Park JS, Bae IG, Eom JS, Lee SR, Cho OH, Choo EJ, Heo JY, Woo JH, Shim TS. Prevalence of latent tuberculosis infection among health care workers in South Korea: a multicenter study. Tuber Respir Dis. 2013;75(1):18–24. doi: 10.4046/trd.2013.75.1.18.
    1. Li J, Munsiff SS, Agerton TB. Prevalence of tuberculin skin test positivity in clinical population in New York City. J Immigr Minor Health. 2010;12(6):816–822. doi: 10.1007/s10903-008-9204-9.
    1. Pareek M, Bond M, Shorey J, Seneviratne S, Guy M, White P, Lalvani A, Kon OM. Community-based evaluation of immigrant tuberculosis screening using interferon gamma release assays and tuberculin skin testing: observational study and economic analysis. Thorax. 2013;68(3):230–239. doi: 10.1136/thoraxjnl-2011-201542.
    1. Shanaube K, Hargreaves J, Fielding K, Schaap A, Lawrence KA, Hensen B, Sismanidis C, Menezes A, Beyers N, Ayles H, Godfrey-Faussett P. Risk factors associated with positive QuantiFERON-TB gold in-tube and tuberculin skin tests results in Zambia and South Africa. PLoS One. 2011;6(4):e18206. doi: 10.1371/journal.pone.0018206.
    1. Mack U, Migliori GB, Sester M, Rieder HL, Ehlers S, Goletti D, Bossink A, Magdorf K, Holscher C, Kampmann B, Arend SM, Detjen A, Bothamley G, Zellweger JP, Milburn H, Diel R, Ravn P, Cobelens F, Cardona PJ, Kan B, Solovic I, Duarte R, Cirillo DM, Lange C. LTBI: latent tuberculosis infection or lasting immune responses to M. tuberculosis? A TBNET consensus statement. Eur Respir J. 2009;33(5):956–973. doi: 10.1183/09031936.00120908.
    1. Kim HJ, Yoon HI, Park KU, Lee CT, Lee JH. The impact of previous tuberculosis history on T-SPOT.TB(R) interferon-gamma release assay results. Int J Tuberc Lung Dis. 2011;15(4):510–516. doi: 10.5588/ijtld.10.0520.
    1. Lalvani A, Pathan AA, McShane H, Wilkinson RJ, Latif M, Conlon CP, Pasvol G, Hill AV. Rapid detection of mycobacterium tuberculosis infection by enumeration of antigen-specific T cells. Am J Respir Crit Care Med. 2001;163(4):824–828. doi: 10.1164/ajrccm.163.4.2009100.
    1. Carrara S, Vincenti D, Petrosillo N, Amicosante M, Girardi E, Goletti D. Use of a T cell-based assay for monitoring efficacy of antituberculosis therapy. Clin Infect Dis. 2004;38(5):754–756. doi: 10.1086/381754.
    1. Hu Y, Zhao Q, Graviss EA, Jiang W, Yuan Z, Xu B. Use of the T-SPOT.TB assay to screen latent tuberculosis infection among the TB contacts in Shanghai, China. J Infect. 2012;65(1):39–48. doi: 10.1016/j.jinf.2012.03.018.
    1. Lienhardt C, Fielding K, Sillah J, Tunkara A, Donkor S, Manneh K, Warndorff D, McAdam KP, Bennett S. Risk factors for tuberculosis infection in sub-Saharan Africa: a contact study in the Gambia. Am J Respir Crit Care Med. 2003;168(4):448–455. doi: 10.1164/rccm.200212-1483OC.
    1. Ozturk N, Surucuoglu S, Ozkutuk N, Gazi H, Akcali S, Koroglu G, Cicek C. Comparison of interferon-gamma whole blood assay with tuberculin skin test for the diagnosis of tuberculosis infection in tuberculosis contacts. Mikrobiyol Bul. 2007;41(2):193–202.
    1. van Zyl-Smit RN, Pai M, Peprah K, Meldau R, Kieck J, Juritz J, Badri M, Zumla A, Sechi LA, Bateman ED, Dheda K. Within-subject variability and boosting of T-cell interferon-gamma responses after tuberculin skin testing. Am J Respir Crit Care Med. 2009;180(1):49–58. doi: 10.1164/rccm.200811-1704OC.

Source: PubMed

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