Stages in the natural history of tuberculosis and the current status and prospect of diagnosis

doi:10.3969/j.issn.1000-6621.2021.11.005

Abstract

Abstract:

From Mycobacterium tuberculosis infection to active disease, it is a complex continuous process that has been artificially separated into many stages. The focus of past studies, diagnostic tests, and pharmacological therapy are mainly on latent infection or active disease. The continuing high epidemic of tuberculosis has led to a gradual focus on other stages. Understanding the definition and characteristics of the different stages in the natural history of tuberculosis is essential for developing new diagnostic techniques and developing more rational interventions. This article provided a review of the definitions and characteristics of the various stages in the natural history of tuberculosis and the current status and prospect of its diagnosis, with the hope to aid in the development of early diagnostic tools and tuberculosis prevention strategies.

Key words: Tuberculosis, Natural history, Diagnosis, Review literature as topic

LI Meng, GAO Qian. Stages in the natural history of tuberculosis and the current status and prospect of diagnosis[J]. Chinese Journal of Antituberculosis, 2021, 43(11): 1125-1131. doi: 10.3969/j.issn.1000-6621.2021.11.005

Figures/Tables 1

References 62

[1]	World Health Organization. The end TB strategy. Geneva: World Health Organization, 2014.
[2]	Arons MM, Hatfield KM, Reddy SC, et al. Presymptomatic SARS-CoV-2 infections and transmission in a skilled nursing facility. N Engl J Med, 2020, 382(22):2081-2090. doi: 10.1056/NEJMoa2008457. doi: 10.1056/NEJMoa2008457
[3]	Gandhi M, Yokoe DS, Havlir DV. Asymptomatic transmission, the Achilles’ Heel of current strategies to control Covid-19. N Engl J Med, 2020, 382(22):2158-2160. doi: 10.1056/NEJMe2009758. doi: 10.1056/NEJMe2009758
[4]	Kendall EA, Shrestha S, Dowdy DW. The epidemiological importance of subclinical tuberculosis: a critical re-appraisal. Am J Respir Crit Care Med, 2020, 203(2):168-174. doi: 10.1164/rccm.202006-2394PP. doi: 10.1164/rccm.202006-2394PP
[5]	Drain PK, Bajema KL, Dowdy D, et al. Incipient and subclinical tuberculosis: a clinical review of early stages and progression of infection. Clin Microbiol Rev, 2018, 31(4):e00021-18. doi: 10.1128/CMR.00021-18. doi: 10.1128/CMR.00021-18
[6]	Achkar JM, Jenny-Avital ER. Incipient and subclinical tuberculosis: defining early disease states in the context of host immune response. J Infect Dis, 2011, 204 Suppl 4(Suppl 4): S1179-86. doi: 10.1093/infdis/jir451. doi: 10.1093/infdis/jir451
[7]	Young DB, Gideon HP, Wilkinson RJ. Eliminating latent tuberculosis. Trends Microbiol, 2009, 17(5):183-188. doi: 10.1016/j.tim.2009.02.005. doi: 10.1016/j.tim.2009.02.005
[8]	World Health Organization. Development of a Target Product Profile (TPP) and a framework for evaluation for a test for predicting progression from tuberculosis infection to active disease. Geneva: World Health Organization, 2017.
[9]	Li H, Wang XX, Wang B, et al. Latently and uninfected healthcare workers exposed to TB make protective antibodies against Mycobacterium tuberculosis. Proc Natl Acad Sci U S A, 2017, 114(19):5023-5028. doi: 10.1073/pnas.1611776114. doi: 10.1073/pnas.1611776114
[10]	World Health Organization. Latent tuberculosis infection: updated and consolidated guidelines for programmatic management. Geneva: World Health Organization, 2014.
[11]	Getahun H, Matteelli A, Chaisson RE, et al. Latent Mycobacterium tuberculosis infection. N Engl J Med, 2015, 372(22):2127-2135. doi: 10.1056/NEJMra1405427. doi: 10.1056/NEJMra1405427
[12]	Lin PL, Ford CB, Coleman MT, et al. Sterilization of granulomas is common in active and latent tuberculosis despite within-host variability in bacterial killing. Nat Med, 2014, 20(1):75-79. doi: 10.1038/nm.3412. doi: 10.1038/nm.3412
[13]	Liu Q, Wei J, Li Y, et al. Mycobacterium tuberculosis clinical isolates carry mutational signatures of host immune environments. Sci Adv, 2020, 6(22): eaba4901. doi: 10.1126/sciadv.aba4901. doi: 10.1126/sciadv.aba4901
[14]	Mack U, Migliori GB, Sester M, et al. 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. doi: 10.1183/09031936.00120908
[15]	Blumberg HM, Ernst JD. The challenge of latent TB infection. JAMA, 2016, 316(9):931-933. doi: 10.1001/jama.2016.11021. doi: 10.1001/jama.2016.11021
[16]	Behr MA, Edelstein PH, Ramakrishnan L. Revisiting the timetable of tuberculosis. BMJ, 2018, 362:k2738. doi: 10.1136/bmj.k2738. doi: 10.1136/bmj.k2738
[17]	Sterling TR, Njie G, Zenner D, et al. Guidelines for the treatment of latent tuberculosis infection: recommendations from the National Tuberculosis Controllers Association and CDC, 2020. MMWR Recomm Rep, 2020, 69(1):1-11. doi: 10.15585/mmwr.rr6901a1. doi: 10.15585/mmwr.rr6901a1
[18]	Stiehm RH. Subclinical pulmonary tuberculosis; a presentation of forty cases. Ann Intern Med, 1940, 13(12):2285-2305. doi: 10.7326/0003-4819-13-12-2285. doi: 10.7326/0003-4819-13-12-2285
[19]	Xu Y, Cancino-Muñoz I, Torres-Puente M, et al. High-resolution mapping of tuberculosis transmission: Whole genome sequencing and phylogenetic modelling of a cohort from Valencia Region, Spain. PLoS Med, 2019, 16(10):e1002961. doi: 10.1371/journal.pmed.1002961. doi: 10.1371/journal.pmed.1002961
[20]	Kendall EA, Kitonsa PJ, Nalutaaya A, et al. The spectrum of tuberculosis disease in an urban ugandan community and its health facilities. Clin Infect Dis, 2021, 72(12):e1035-e1043. doi: 10.1093/cid/ciaa1824. doi: 10.1093/cid/ciaa1824
[21]	全国第五次结核病流行病学抽样调查技术指导组, 全国第五次结核病流行病学抽样调查办公室. 2010年全国第五次结核病流行病学抽样调查报告. 中国防痨杂志, 2012, 34(8):485-508.
[22]	Loudon RG, Roberts RM. Droplet expulsion from the respiratory tract. Am Rev Respir Dis, 1967, 95(3):435-442. doi: 10.1164/arrd.1967.95.3.435. doi: 10.1164/arrd.1967.95.3.435
[23]	van’t Hoog AH, Laserson KF, Githui WA, et al. High preva-lence of pulmonary tuberculosis and inadequate case finding in rural western Kenya. Am J Respir Crit Care Med, 2011, 183(9):1245-1253. doi: 10.1164/rccm.201008-1269OC. doi: 10.1164/rccm.201008-1269OC
[24]	Onozaki I, Law I, Sismanidis C, et al. National tuberculosis prevalence surveys in Asia, 1990—2012: an overview of results and lessons learned. Trop Med Int Health, 2015, 20(9):1128-1145. doi: 10.1111/tmi.12534. doi: 10.1111/tmi.12534
[25]	Behr MA, Warren SA, Salamon H, et al. Transmission of Mycobacterium tuberculosis from patients smear-negative for acid-fast bacilli. Lancet, 1999, 353(9151):444-449. doi: 10.1016/s0140-6736(98)03406-0. doi: 10.1016/s0140-6736(98)03406-0
[26]	Tostmann A, Kik SV, Kalisvaart NA, et al. Tuberculosis transmission by patients with smear-negative pulmonary tuberculosis in a large cohort in the Netherlands. Clin Infect Dis, 2008, 47(9):1135-1142. doi: 10.1086/591974. doi: 10.1086/591974
[27]	Hernández-Garduño E, Cook V, Kunimoto D, et al. Transmission of tuberculosis from smear negative patients: a mole-cular epidemiology study. Thorax, 2004, 59(4):286-290. doi: 10.1136/thx.2003.011759. doi: 10.1136/thx.2003.011759
[28]	Lohmann EM, Koster BF, le Cessie S, et al. Grading of a positive sputum smear and the risk of Mycobacterium tuberculosis transmission. Int J Tuberc Lung Dis, 2012, 16(11):1477-1484. doi: 10.5588/ijtld.12.0129. doi: 10.5588/ijtld.12.0129
[29]	Yang C, Shen X, Peng Y, et al. Transmission of Mycobacterium tuberculosis in China: a population-based molecular epidemiologic study. Clin Infect Dis, 2015, 61(2):219-227. doi: 10.1093/cid/civ255. doi: 10.1093/cid/civ255
[30]	Patterson B, Wood R. Is cough really necessary for TB transmission? Tuberculosis (Edinb), 2019, 117:31-35. doi: 10.1016/j.tube.2019.05.003. doi: 10.1016/j.tube.2019.05.003
[31]	Loudon RG, Roberts RM. Singing and the dissemination of tuberculosis. Am Rev Respir Dis, 1968, 98(2):297-300. doi: 10.1164/arrd.1968.98.2.297. doi: 10.1164/arrd.1968.98.2.297
[32]	Esmail H, Dodd PJ, Houben RMGJ. Tuberculosis transmission during the subclinical period: could unrelated cough play a part? Lancet Respir Med, 2018, 6(4):244-246. doi: 10.1016/S2213-2600(18)30105-X. doi: 10.1016/S2213-2600(18)30105-X
[33]	Houben RMGJ, Esmail H, Emery JC, et al. Spotting the old foe-revisiting the case definition for TB. Lancet Respir Med, 2019, 7(3):199-201. doi: 10.1016/S2213-2600(19)30038-4. doi: 10.1016/S2213-2600(19)30038-4
[34]	Tiemersma EW, van der Werf MJ, Borgdorff MW, et al. Natural history of tuberculosis: duration and fatality of untreated pulmonary tuberculosis in HIV negative patients: a systematic review. PLoS One, 2011, 6(4):e17601. doi: 10.1371/journal.pone.0017601. doi: 10.1371/journal.pone.0017601
[35]	中国防痨协会, 中国防痨协会学校与儿童结核病防治专业分会, 《中国防痨杂志》编辑委员会. 重组结核杆菌融合蛋白(EC)临床应用专家共识. 中国防痨杂志, 2020, 42(8):761-768. doi: 10.3969/i.issn.1000-6621.2020.08.001. doi: 10.3969/i.issn.1000-6621.2020.08.001
[36]	O’Garra A, Redford PS, McNab FW, et al. The immune response in tuberculosis. Annu Rev Immunol, 2013, 31:475-527. doi: 10.1146/annurev-immunol-032712-095939. doi: 10.1146/annurev-immunol-032712-095939
[37]	Liao CH, Lai CC, Tan CK, et al. False-negative results by enzyme-linked immunospot assay for interferon-gamma among patients with culture-confirmed tuberculosis. J Infect, 2009, 59(6):421-423. doi: 10.1016/j.jinf.2009.09.012. doi: 10.1016/j.jinf.2009.09.012
[38]	Dorman SE, Belknap R, Graviss EA, et al. Interferon-gamma release assays and tuberculin skin testing for diagnosis of latent tuberculosis infection in healthcare workers in the United States. Am J Respir Crit Care Med, 2014, 189(1):77-87. doi: 10.1164/rccm.201302-0365OC. doi: 10.1164/rccm.201302-0365OC
[39]	Zhou G, Luo Q, Luo S, et al. Interferon-gamma release assays or tuberculin skin test for detection and management of latent tuberculosis infection: a systematic review and meta-analysis. Lancet Infect Dis, 2020, 20(12):1457-1469. doi: 10.1016/S1473-3099(20)30276-0. doi: 10.1016/S1473-3099(20)30276-0
[40]	Mendelsohn SC, Fiore-Gartland A, Penn-Nicholson A, et al. Validation of a host blood transcriptomic biomarker for pulmonary tuberculosis in people living with HIV: a prospective diagnostic and prognostic accuracy study. Lancet Glob Health, 2021, 9(6):e841-e853. doi: 10.1016/S2214-109X(21)00045-0. doi: 10.1016/S2214-109X(21)00045-0
[41]	Blount RJ, Tran MC, Everett CK, et al. Tuberculosis progression rates in U.S. Immigrants following screening with interferon-gamma release assays. BMC Public Health, 2016, 16(1):875. doi: 10.1186/s12889-016-3519-6. doi: 10.1186/s12889-016-3519-6
[42]	Zak DE, Penn-Nicholson A, Scriba TJ, et al. A blood RNA signature for tuberculosis disease risk: a prospective cohort study. Lancet, 2016, 387(10035):2312-2322. doi: 10.1016/S0140-6736(15)01316-1. doi: 10.1016/S0140-6736(15)01316-1
[43]	Scriba TJ, Penn-Nicholson A, Shankar S, et al. Sequential inflammatory processes define human progression from M.tuberculosis infection to tuberculosis disease. PLoS Pathog, 2017, 13(11):e1006687. doi: 10.1371/journal.ppat.1006687. doi: 10.1371/journal.ppat.1006687
[44]	Gupta RK, Turner CT, Venturini C, et al. Concise whole blood transcriptional signatures for incipient tuberculosis: a systematic review and patient-level pooled meta-analysis. Lancet Respir Med, 2020, 8(4):395-406. doi: 10.1016/S2213-2600(19)30282-6. doi: 10.1016/S2213-2600(19)30282-6
[45]	Weiner J 3rd, Maertzdorf J, Sutherland JS, et al. Metabolite changes in blood predict the onset of tuberculosis. Nat Commun, 2018, 9(1):5208. doi: 10.1038/s41467-018-07635-7. doi: 10.1038/s41467-018-07635-7
[46]	Gupta RK, Calderwood CJ, Yavlinsky A, et al. Discovery and validation of a personalized risk predictor for incident tuberculosis in low transmission settings. Nat Med, 2020, 26(12):1941-1949. doi: 10.1038/s41591-020-1076-0. doi: 10.1038/s41591-020-1076-0
[47]	Mpande CAM, Rozot V, Mosito B, et al. Immune profiling of Mycobacterium tuberculosis-specific T cells in recent and remote infection. EBioMedicine, 2021, 64:103233. doi: 10.1016/j.ebiom.2021.103233. doi: 10.1016/j.ebiom.2021.103233
[48]	Jiang Q, Ji L, Qiu Y, et al. A randomised controlled trial of stepwise sputum collection to increase yields of confirmed tuberculosis. Int J Tuberc Lung Dis, 2019, 23(6):685-691. doi: 10.5588/ijtld.18.0524. doi: 10.5588/ijtld.18.0524
[49]	Dodd PJ, Gardiner E, Coghlan R, et al. Burden of childhood tuberculosis in 22 high-burden countries: a mathematical modelling study. Lancet Glob Health, 2014, 2(8):e453-9. doi: 10.1016/S2214-109X(14)70245-1. doi: 10.1016/S2214-109X(14)70245-1
[50]	World Health Organization. The use of lateral flow urine lipoarabinomannan assay (LF-LAM) for the diagnosis and screening of active tuberculosis in people living with HIV. Geneva: World Health Organization, 2015.
[51]	Shah M, Hanrahan C, Wang ZY, et al. Lateral flow urine lipoarabinomannan assay for detecting active tuberculosis in HIV-positive adults. Cochrane Database Syst Rev, 2016, 2016(5): CD011420. doi: 10.1002/14651858.CD011420.pub2. doi: 10.1002/14651858.CD011420.pub2
[52]	Nkereuwem E, Togun T, Gomez MP, et al. Comparing accuracy of lipoarabinomannan urine tests for diagnosis of pulmonary tuberculosis in children from four African countries: a cross-sectional study. Lancet Infect Dis, 2021, 21(3):376-384. doi: 10.1016/S1473-3099(20)30598-3. doi: 10.1016/S1473-3099(20)30598-3
[53]	Warsinske HC, Rao AM, Moreira FMF, et al. Assessment of Validity of a Blood-Based 3-Gene Signature Score for Progression and Diagnosis of Tuberculosis, Disease Severity, and Treatment Response. JAMA Netw Open, 2018, 1(6):e183779. doi: 10.1001/jamanetworkopen.2018.3779. doi: 10.1001/jamanetworkopen.2018.3779
[54]	Ahmad R, Xie L, Pyle M, et al. A rapid triage test for active pulmonary tuberculosis in adult patients with persistent cough. Sci Transl Med, 2019, 11(515): eaaw8287. doi: 10.1126/scitranslmed.aaw8287. doi: 10.1126/scitranslmed.aaw8287
[55]	寿娟, 谢青梅, 龙昭玲, 等. 胸水游离DNA的结核杆菌检测在结核病诊断中的价值. 中华病理学杂志, 2018, 47(6):465-467. doi: 10.3760/cma.j.issn.0529-5807.2018.06.016. doi: 10.3760/cma.j.issn.0529-5807.2018.06.016
[56]	韩冰, 胡柳杨, 姚亚超, 等. 血浆结核分枝杆菌游离DNA检测对结核病的诊断价值. 临床肺科杂志, 2020, 25(6):883-887. doi: 10.3969/j.issn.1009-6663.2020.06.018. doi: 10.3969/j.issn.1009-6663.2020.06.018
[57]	韩冰, 胡柳杨, 曹东林. 游离DNA检测在结核病诊断中的研究进展. 检验医学与临床, 2020, 17(3):419-423. doi: 10.3969/j.issn.1672-9455.2020.03.042. doi: 10.3969/j.issn.1672-9455.2020.03.042
[58]	Oreskovic A, Panpradist N, Marangu D, et al. Diagnosing pulmonary tuberculosis by using sequence-specific purification of urine cell-free DNA. J Clin Microbiol, 2021, 59(8):e0007421. doi: 10.1128/JCM.00074-21. doi: 10.1128/JCM.00074-21
[59]	Beccaria M, Mellors TR, Petion JS, et al. Preliminary investigation of human exhaled breath for tuberculosis diagnosis by multidimensional gas chromatography-Time of flight mass spectrometry and machine learning. J Chromatogr B Analyt Technol Biomed Life Sci, 2018, 1074-1075:46-50. doi: 10.1016/j.jchromb.2018.01.004. doi: 10.1016/j.jchromb.2018.01.004
[60]	Beccaria M, Bobak C, Maitshotlo B, et al. Exhaled human breath analysis in active pulmonary tuberculosis diagnostics by comprehensive gas chromatography-mass spectrometry and chemometric techniques. J Breath Res, 2018, 13(1):016005. doi: 10.1088/1752-7163/aae80e. doi: 10.1088/1752-7163/aae80e
[61]	Saktiawati AMI, Triyana K, Wahyuningtias SD, et al. eNose-TB: A trial study protocol of electronic nose for tuberculosis screening in Indonesia. PLoS One, 2021, 16(4):e0249689. doi: 10.1371/journal.pone.0249689. doi: 10.1371/journal.pone.0249689
[62]	Hoang LT, Jain P, Pillay TD, et al. Transcriptomic signatures for diagnosing tuberculosis in clinical practice: a prospective, multicentre cohort study. Lancet Infect Dis, 2021, 21(3):366-375. doi: 10.1016/S1473-3099(20)30928-2. doi: 10.1016/S1473-3099(20)30928-2