One-quarter of the world’s population is estimated to be infected with Mycobacterium tuberculosis, mostly as a latent tuberculosis infection (LTBI). Systematic testing and treatment of LTBI are central to the World Health Organization’s (WHO) “End TB Strategy” of eliminating tuberculosis (TB). Groups at higher risk of TB include people with recent exposure to M. tuberculosis, those with underlying conditions who experience reactivation of a remotely acquired infection, and migrants from high-prevalence countries. Therefore, targeting these at-risk groups has become a priority. However, this approach is limited by the deficiencies of the diagnostic tests for TB infection, the long duration and toxicity of the treatment, and the dropouts along the cascade of care.
The available methods for the diagnosis of TB have a poor ability to accurately identify those people with an actual risk of progression to TB, who in turn would benefit most from preventive therapy. Undoubtedly, there has been progress in the last two decades with the introduction of the in vitro interferon-gamma release assays (IGRAs) for the diagnosis of LTBI. In addition, evidence on the better tolerance of shorter rifamycin-based regimens has been generated in the latest years. Nevertheless, many people are still needed to treat to prevent a single case of TB, and treatment compliance rates are low. Finally, even more accurate diagnostic tests and more convenient preventive treatments were available, the effectiveness of LTBI treatment ultimately relies on engaging and retaining eligible people in cascade of care.
This Research Topic will focus on a broad range of aspects of LTBI, spanning from basic research and its clinical applicability, and new approaches to diagnosing and managing LTBI in different clinical scenarios.
We welcome submissions of original research, reviews and systematic reviews (A-type articles), brief research reports and mini-reviews (B-type articles), and opinions (C-type articles) on the subtopics of the following, but not limited to:
· Markers of LTBI and progression to active disease (metabolomic, transcriptomic, and immunologic markers)
· Markers to distinguish latent from active TB
· Diagnostic and treatment of LTBI in different clinical scenarios (contact of TB, pre-transplant, and pre-biological therapy)
· Care models and cascade of care for LTBI in low- and high-prevalence settings
· Strategies to engage and retain difficult-to-reach populations for screening and treatment of LTBI
One-quarter of the world’s population is estimated to be infected with Mycobacterium tuberculosis, mostly as a latent tuberculosis infection (LTBI). Systematic testing and treatment of LTBI are central to the World Health Organization’s (WHO) “End TB Strategy” of eliminating tuberculosis (TB). Groups at higher risk of TB include people with recent exposure to M. tuberculosis, those with underlying conditions who experience reactivation of a remotely acquired infection, and migrants from high-prevalence countries. Therefore, targeting these at-risk groups has become a priority. However, this approach is limited by the deficiencies of the diagnostic tests for TB infection, the long duration and toxicity of the treatment, and the dropouts along the cascade of care.
The available methods for the diagnosis of TB have a poor ability to accurately identify those people with an actual risk of progression to TB, who in turn would benefit most from preventive therapy. Undoubtedly, there has been progress in the last two decades with the introduction of the in vitro interferon-gamma release assays (IGRAs) for the diagnosis of LTBI. In addition, evidence on the better tolerance of shorter rifamycin-based regimens has been generated in the latest years. Nevertheless, many people are still needed to treat to prevent a single case of TB, and treatment compliance rates are low. Finally, even more accurate diagnostic tests and more convenient preventive treatments were available, the effectiveness of LTBI treatment ultimately relies on engaging and retaining eligible people in cascade of care.
This Research Topic will focus on a broad range of aspects of LTBI, spanning from basic research and its clinical applicability, and new approaches to diagnosing and managing LTBI in different clinical scenarios.
We welcome submissions of original research, reviews and systematic reviews (A-type articles), brief research reports and mini-reviews (B-type articles), and opinions (C-type articles) on the subtopics of the following, but not limited to:
· Markers of LTBI and progression to active disease (metabolomic, transcriptomic, and immunologic markers)
· Markers to distinguish latent from active TB
· Diagnostic and treatment of LTBI in different clinical scenarios (contact of TB, pre-transplant, and pre-biological therapy)
· Care models and cascade of care for LTBI in low- and high-prevalence settings
· Strategies to engage and retain difficult-to-reach populations for screening and treatment of LTBI