Latent tuberculosis infection: opportunities for diagnosis and treatment in HIV-infected patients


DOI: https://dx.doi.org/10.18565/epidem.2019.9.2.99-104

Russkikh O.E.

Izhevsk State Medical Academy, Ministry of Health of Russia, Izhevsk, Russia
The paper presents the currently available data in the Russian and foreign literature on latent tuberculosis infection (LTBI) and its role in the risk of tuberculosis (TB) in various population groups, including in those with HIV infection. The greatest risk of TB in people with LTBI is shown to occur in HIV infection: it increases by 10% every year. Allergy skin tests (Mantoux test and Diaskintest), detection of MBT antigens (PCR) and antibodies (ELISA) and in vitro tests based on the production of interferon-γ by various MBT antigens are now used in the Russian Federation for the diagnosis of LTBI. Based on the findings, the author defines treatment tactics and regimen for LTBI. The paper considers the topical issues of chemoprophylaxis of TB in HIV-infected patients and presents effective treatment regimens aimed at reducing the risk of TB reactivation rates and adverse reactions and at lowering the drug load on the patient. Obtaining new LTBI knowledge will contribute to the solution of the important task – to the control of the progression of TB in patients with HIV infection.
Keywords: concurrent tuberculosis, allergy skin tests, latent tuberculosis infection, chemoprophylaxis, HIV infection, treatment
Read entire article

Literature

  1. Gergert V.Ya., Eremeev V.V. [Problems of immunodiagnosis in tuberculosis]. Vestnik Central’nogo nauchno-issledovatel’skogo instituta tuberkuleza 2019; (1): 5–11. (In Russ.).
  2. Nechaeva O.B. [Tuberculosis and HIV monitoring in the Russian Federation]. Zdravoohranenie Rossiyskoy Federatsii 2012; (2): 18–23. (In Russ.).
  3. Bogorodskaya E.M., Litvinov V.I., Belilovskу E.M. [Anti-tuberculosis work in the city of Moscow. Analytical review of statistical indicators for tuberculosis]. Мoscow, 2017. 294 p. (In Russ.).
  4. Samandari T. Preliminary results of the Botswana isoniazid preventive therapy (IPT) clinical trial. In: Proceedings of the 40th World Conference on Lung Health of the International Union Against Tuberculosis and Lung Disease. 3–7 December 2009, Cancun, Mexico.
  5. Litvinov V.I. [«Dormant» bacilli, loci dormant, latent TB infection]. Tuberkulez i sotsialno znachimyie zabolevaniya 2016; (2): 5–13. (In Russ.).
  6. Dorozhkova I.R. [Latent (hidden) tuberculosis infection – a natural phase of persistence of the pathogen in the infected body]. Tuberkulez i sotsialno znachimyie zabolevaniya 2014; (4): 66–78. (In Russ.).
  7. Mack U., Migliori G., Sester M. et al. LTBI: latent tuberculosis infection or lasting immune responses to M. tuberculosis? A TBNET consensus statement. Eur. Respir. J. 2009; (33): 56–73.
  8. Aksenova V.A., Baryishnikova L.A., Dolzhenko E.N., Kudlay D.A. [Topical issues of mass examination of the child population for tuberculosis in modern conditions]. Doktor. Ru 2012; (8): 27–9. (In Russ.).
  9. Aksenova V.A., Klevno N.I., Baryishnikova L.A., Kudlay D.A., Nikolenko N.Yu., Kurilla A.A. [Detection of tuberculosis and tactics of dispensary monitoring of persons at risk using recombinant tuberculosis allergen – Diaskintest. Methodical recommendation]. Мoscow, 2011. http://diaskintest.ru/pdfs/metodicheskie_rekomendacii.pdf (In Russ.).
  10. Sinitsyn M.V., Kravtsova D.V., Belilovsky E.M. [Economic efficiency of diagnosis of latent tuberculosis infection and chemoprophylaxis of tuberculosis in patients with HIV infection]. Tuberkulez i sotsialno znachimyie zabolevaniya 2018; (3): 4–12. (In Russ.).
  11. Akolo C., Adetufa I., Shepperd S., Volmink J. Treatment of latent tuberculosis infection in HIV infected persons. Cochrane Database Syst. Rev. 2010; (20): CD000171. [Электронный ресурс]. http: //www.cochrane.org
  12. Benator D., Bhattacharya M. Rifapentine and isoniazid once a week versus rifampicin and isoniazid twice a week for treatment of drug-susceptible pulmonary tuberculosis in HIV-negative patients: a randomized clinical trial. Lancet 2002; (360): 528–34.
  13. Slogotskaya L.V., Bogorodskaya E., Ivanova D., Makarova M., Guntupova L., Litvinov V., Seltsovsky P., Kudlay D.A., Nikolenko N. Sensitivity and specifity of new skin with recombinant protein CFP10-ESAT6 in patiens with tuberculosis, and individualis with non-tuberculosis diseases. Eur. Respir. J. 2013; 42 (S57): 1995.
  14. Pokrovsky V.V., Ladnaya N.N., Tushina O.I., Burovtseva E.V. [HIV infection. Fact sheet № 40]. Мoscow, 2015. (In Russ.).
  15. Goluba J.E., Pronykc P., Mohapie L. et al. Isoniazid preventive therapy, HAART and tuberculosis risk in HIV-infected adults in South Africa: a prospective cohort. AIDS 2009; (5): 631–6.
  16. Cлогоцкая Л.В., Богородская Е.М. [Comparative characteristics of immunological tests to detect tuberculosis infection. Mass screening capability]. Tuberkulez i bolezni legkih 2016; (5): 5–16. (In Russ.).
  17. Menzies D., Pai M., Comstock G. Meta-analysis: new tests for the diagnosis of latent tuberculosis infection: areas of uncertainty and recommendations for research. Ann. Intern. Med. 2007; (146): 340–54.
  18. Rangaka M., Wilkinson K., Giynn J. et al. Predictive value of interferon-γ release assays for incident active tuberculosis: a systematic review and meta-analysis. Lancet Infect. Dis. 2012; (12): 45–55.
  19. Parfenova Т.А. [Experience in the use of tuberculosis allergen recombinant for the diagnosis of tuberculosis infection in antitubercular institution]. Tuberkulez i bolezni legkih 2016; (9): 49–52. (In Russ.).
  20. Aksenova V.А., Levi D.Т., Aleksandrova N.V., Kudlay D.A. [The current state of the issue of the incidence of tuberculosis in children, drugs for the prevention and diagnosis of infection]. Biopreparaty. Profilaktika. diagnostika. lecheniye 2017; (3): 145–51. (In Russ.).
  21. Aksenova V.А., Baryishnikova L.A., Klevno N.I., Sokolskaya E.A., Dolzhenko E.N., Shuster A.M., Martyanov V.A., Kudlay D.A., Nikolenko N.Yu., Kurilla A.A. [New opportunities for screening and diagnosis of various manifestations of tuberculosis infection in children and adolescents in Russia]. Voprosy sovremennoy pediatrii 2011; (4): 16–22. (In Russ.).
  22. Filimonov P.N. [On the discussion of latent tuberculosis infection]. Tuberkulez i bolezni legkih 2014; (5): 69–73. (In Russ.).
  23. Al-Orainey I. Diagnosis of latent tuberculosis: Can we do better? Ann. Thorac. Med. 2009; 4(1): 5–9.
  24. Vasileva I.A., Belilovskiy E.M., Borisov S.E., Sterlikov S.A. [Global reports of the world health organization on tuberculosis: formation and interpretation]. Tuberkulez i bolezni legkih 2017; (5): 7–14. (In Russ.).
  25. Slogotskaya L.I., Litvinov V.I., Seltsovsky P.P., Shuster A.M., Martyanov V.A., Kudlay D.A., Filippov A.V., Kochetkov Ya.A. [The use of a skin sample with a recombinant tuberculosis allergen (Diaskintest®) for the diagnosis of tuberculosis infection in patients with HIV infection]. Pulmonologiya 2011; (1): 60–4. (In Russ.).
  26. Ahmad S. Pathogenesis, immunology, and diagnosis of latent mycobacterium tuberculosis infection. Clin. Dev. Immunol. 2011; AID 814943, 17 p. DOI:10.1155/2011/814943.
  27. Lin M., Ottenhoff T. Host-pathogen interactions in latent Mycobacterium tuberculosis infection: identification of new targets for tuberculosisintervention. Endocr. Metab. Immune Disord. Drug Targets 2008; (8): 15–29.
  28. Getahun H., Gunneberg C., Granich R., Nunn P. HIV infection-associated: The epidemiology and the response. Clin. Infect. Dis. 2010; (50): 201–7.
  29. Litvinova N.V., Ivanushkina T.N., Slogotskaya A.V., Ivanova D.A., Borisova S.E. [Safety and efficacy of rifampicin in the treatment of respiratory tuberculosis with preserved drug sensitivity of the pathogen]. Tuberkulez i bolezni legkih 2013; (6): 46–51.


About the Autors

Oleg E. Russkikh, MD, Associate Professor, Head, Department of Phthisiology, Izhevsk State Medical Academy, Ministry of Health of Russia, Izhevsk, Russia, e-mail: olegr22@mail.ru


Similar Articles

Back to Content

Бионика Медиа