在QuantiFERON-TB Gold Plus测试中CD8+ T细胞反应与肺结核复发有关:为期2年的前性研究
Henan Xin1,2, Xuefang Cao1,2, Boxuan Feng1,2
1NHC Key Laboratory of Systems Biology of Pathogens, National Institute of Pathogen Biology, and Center for Tuberculosis Research, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, P.R. China.
Infectious diseases (London, England)
|February 6, 2024
概括
肺结核 (PTB) 的复发是一个挑战. 量子菲龙-结核病黄金Plus (QFT-Plus) 可以识别高风险的个人PTB复发,包括老年吸烟者和最近有结核病史的人.
科学领域:
- 传染性疾病 传染性疾病
- 公共卫生 公共卫生
- 免疫学 免疫学 免疫学
背景情况:
- 肺结核 (PTB) 的复发是中国有效控制PTB的重大障碍.
- 识别具有PTB复发高风险的个体对于有针对性的干预至关重要.
研究的目的:
- 确定与曾经经治疗过PTB的个体中PTB复发相关的潜在风险因素.
- 评估QuantiFERON-TB Gold Plus (QFT-Plus) 在识别患有PTB复发风险增加的个人的实用性.
主要方法:
- 一项前性研究招募了在2016年之前被诊断患有PTB的18岁以上的个体,该地区的TB流行率平均.
- 基线评估包括胸部放射,QuantiFERON-TB金管内 (QFT-GIT) 和QFT-Plus测试.
- 参与者被跟踪了2年,以追踪PTB复发.
主要成果:
- 超过一半 (52.34%) 的参与者在基线检测出QFT-Plus阳性;21个人在2年内出现结核病复发.
- 复发的危险因素包括年龄≥60岁 (aOR=3.97),最近结核病史 (aOR=7.71) 和吸烟 (aOR=4.56).
- QFT-Plus阳性,特别是TB2+/TB1- (aOR=15.34),与复发风险有很强的相关性,显示了与TB2-TB1水平 (p<0.001) 的剂量反应关系.
结论:
- 这项研究强调了结核病感染的高负担和研究人口中PTB复发的重大风险.
- 老年人,吸烟者以及最近有PTB病史的人群风险较高.
- QFT-Plus阳性,特别是TB2单一阳性,是识别需要对活跃结核病进行更密切监测的个体的有价值标记.
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