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Review
. 2021 Sep;17(3):210079.
doi: 10.1183/20734735.0079-2021.

The definition of tuberculosis infection based on the spectrum of tuberculosis disease

Giovanni Battista Migliori  1 , Catherine W M Ong  2   3 , Linda Petrone  4 , Lia D'Ambrosio  5 , Rosella Centis  1 , Delia Goletti  4
Affiliations
Review

The definition of tuberculosis infection based on the spectrum of tuberculosis disease

Giovanni Battista Migliori et al. Breathe (Sheff). 2021 Sep.

Abstract

Latent tuberculosis infection was the term traditionally used to indicate tuberculosis (TB) infection. This term was used to define "a state of persistent immune response to stimulation by Mycobacterium tuberculosis antigens through tests such as the tuberculin skin test (TST) or an interferon-γ release assay (IGRA) without clinically active TB". Recent evidence indicates that the spectrum from TB infection to TB disease is much more complex, including a "continuum" of situations didactically reported as uninfected individual, TB infection, incipient TB, subclinical TB without signs/symptoms, subclinical TB with unrecognised signs/symptoms, and TB disease with signs/symptoms. Recent evidence suggests that subclinical TB is responsible for important M. tuberculosis transmission. This review describes the different stages described above and their relationships. It also summarises the new developments in prevention, diagnosis and treatment of TB infection as well as their public health and policy implications.

Educational aims: To describe the evolution of the definition of "tuberculosis infection" and didactically describe the continuum of stages existing between TB infection and disease.To discuss the recommended approaches to prevent, diagnose and treat TB infection.

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Conflict of interest statement

Conflict of interest: D. Goletti reports grants (to her institution) and consulting fees from Biomerieux and consulting fees and payment or honoraria for a lecture from Qiagen, outside the submitted work. G.B. Migliori, C.W.M. Ong, L. Petrone, L. D'Ambrosio and R. Centis have nothing to disclose.

Figures

Figure 1
Figure 1
The “continuum process” leading from TB infection to disease. BCG: bacille Calmette–Guérin; DX: diagnosis; TX: treatment; IGRAs: interferon-γ release assays; TST: tuberculin skin test; (L)TBI: (latent) TB infection.
See this image and copyright information in PMC

References

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