ArticleClinical infectious diseases : an official publication of the Infectious Diseases Society of America2019
Long-term Stability of Resistance to Latent Mycobacterium tuberculosis Infection in Highly Exposed Tuberculosis Household Contacts in Kampala, Uganda.
Article in Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 51 papers.
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Who cites it
51 citing papers in PubMed, 71 citations in OpenAlex.
- Monocyte metabolic transcriptional programs associate with resistance to tuberculin skin test/interferon-γ release assay conversion.The Journal of clinical investigation · 2021Trial
- Context-dependent risk stratification using a tuberculin skin test induration threshold of ≥ 15 mm in school tuberculosis screening in Hangzhou, China: a historical cohort study.Tropical medicine and health · 2026Article
- Circulating metabolites associated with protection against Mycobacterium tuberculosis infection and inhibition of mycobacterial growth.Communications biology · 2026Article
- Tuberculosis in households with infectious cases in Kampala city: Harnessing health data science for new insights on an ancient disease with persistent, unresolved problems (DS-IAFRICA-TB) Study Protocol.medRxiv : the preprint server for health sciences · 2026Article
- Controlled human infection with Mycobacterium tuberculosis: practical considerations for clinical trials.The Lancet. Microbe · 2026Review
- A proteome-wide atlas of humoral immunity toFrontiers in immunology · 2026Article
- Prior Exposure of Airway Epithelial Cells to Mycobacteria Reduces Subsequent <italic>Mycobacterium tuberculosis</italic> Infection and Resulting Inflammation.Journal of innate immunity · 2026Article
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- Alveolar macrophage transcriptional signatures associated with resistance to TST/IGRA conversion following Mycobacterium tuberculosis exposure.BMC genomics · 2025Article
- A human YEATS4 variant confers resistance to TST and IGRA conversion despite Mycobacterium tuberculosis exposure.Genome medicine · 2025Article
- Host-intrinsic and host-extrinsic factors modulate immunity to Mtb infection, reinfection, and noncanonical vaccination routes.Cell reports. Medicine · 2025Review
- Insights into protection against Mycobacterium tuberculosis infection: time to officially confirm another phenotype?The Journal of clinical investigation · 2025Article
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- Mycobacterium tuberculosis resisters despite HIV exhibit activated T cells and macrophages in their pulmonary alveoli.The Journal of clinical investigation · 2025Article
- Association of Mycobacterium tuberculosis aerosolization and HIV coinfection in the index case with T cell responses in household contacts.Scientific reports · 2025Article
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- Article
- Household contact antigen-speciResearch square · 2024Article
- Epigenetic programming of host lipid metabolism associated with resistance to TST/IGRA conversion after exposure tomSystems · 2024Article
- Recasting resistance to Mycobacterium tuberculosis.Nature immunology · 2024Article
Corrections and comments
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Authors and funding
10 authors at 3 institutions in 2 countries.
Funding
Abstract
backgroundResistance to latent Mycobacterium tuberculosis (M.tb) infection, identified by persistently negative tuberculin skin tests (TST) and interferon-gamma release assays (IGRA), after close contact with pulmonary tuberculosis (TB) patients has not been extensively characterized. Stability of this "resistance" beyond 2 years from exposure is unknown.
methods407 of 657 eligible human immunodeficiency virus (HIV)-negative adults from a TB household contact study with persistently negative TST (PTST-) or with stable latent M.tb infection (LTBI) were retraced 9.5 years (standard deviation = 3.2) later. Asymptomatic retraced contacts underwent 3 IGRAs and follow-up TST, and their M.tb infection status classified as definite/possible/probable.
resultsAmong PTST- with a definite classification, 82.7% were concordantly TST-/ quantiferon-TB Gold- (QFT-), and 16.3% converted to TST+/QFT+ LTBI. Among original LTBI contacts, 83.6% remained LTBI, and 3.9% reverted their TST and were QFT-. Although TST and QFT concordance was high (κ = 0.78), 1.0% of PTST and 12.5% of original LTBI contacts could not be classified due to discordant TST and QFT results. Epidemiological variables did not differ between retraced PTST- and LTBI contacts.
conclusionResistance to LTBI, defined by repeatedly negative TST and IGRA, in adults who have had close contact with pulmonary TB patients living in TB-endemic areas, is a stable outcome of M.tb exposure. Repeated longitudinal measurements with 2 different immune assays and extended follow-up provide enhanced discriminatory power to identify this resister phenotype and avoid misclassification. Resisters may use immune mechanisms to control aerosolized M.tb that differ from those used by persons who develop "classic" LTBI.
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