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Evaluation of the Xpert MTB Host Response assay for the triage of patients [TB0108]

A triage test with a minimum sensitivity of 90% and specificity of 70%, meeting predefined operational targets, could help reduce underdiagnosis and misdiagnosis of tuberculosis, decrease delays in starting treatment, and lower the cost and infrastructure demands of current gold-standard sputum-based tests in high-burden settings.  Sweeney and colleagues validated a three-gene host blood signature, utilizing blood mRNA to measure markers associated with the host inflammatory response, which can differentiate tuberculosis disease from other conditions. This signature has been developed into an automated, blood-based quantitative PCR test on the GeneXpert platform, generating a TB Score based on the cycle threshold of expressed genes. Early studies from stored samples and interim results from a multisite study suggest that this test may achieve the WHO's target product profile minimum accuracy threshold for a tuberculosis triage test. We aimed to prospectively evaluate the diagnostic...
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Adults with Mtb infection and pre-DM have increased levels of IGR [TB0102]

Immunopathy associated with diabetes or pre-diabetes is characterized, in part, by chronic inflammation driven by persistent hyperglycemia, resulting in several complications. Generally, data from clinical tuberculosis (TB) studies indicate that patients with diabetes demonstrate a robust TB antigen-specific immune response. However, diabetes is paradoxically associated with worse TB clinical outcomes, including delayed culture conversion, increased risk of mortality, and higher rates of TB relapse. Although diabetes is an established risk factor for TB disease, additional information to identify individuals with diabetes and latent TB infection (LTBI) at greatest risk of progression to TB disease is urgently needed. Previous studies among children, adolescents, and adults who converted from a negative to a positive LTBI test reported that increased quantitative QuantiFERON-TB Gold (QFT) interferon-gamma (IFN-γ) values were predictive of progression to TB disease. Participants who self...
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Health status and treatment outcome of TB with DM cases, Gujarat [TB0104]

The world is undergoing an epidemiological transition in disease burden, with a gradual decline in deaths from communicable diseases (CDs) and a steady rise in non-communicable diseases (NCDs). This shift has intensified competition for policy attention and resources between advocates for CDs, such as tuberculosis (TB), and those focused on NCDs, like cardiovascular diseases and diabetes mellitus (DM). The global increase in type 2 DM has emerged as a substantial challenge for TB control, as today more TB patients are living with diabetes than with concomitant human immunodeficiency virus (HIV) infection. Thus, the association between DM and TB may become the next significant challenge for global TB control. The bidirectional relationship between TB and DM is well-documented. Diabetes is an independent risk factor for TB development, while TB can also lead to impaired glucose tolerance (IGT) and new-onset diabetes. Additionally, diabetes may alter TB symptoms, radiological findings, ...
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