TY - JOUR
T1 - Incipient and subclinical tuberculosis
T2 - A clinical review of early stages and progression of infection
AU - Drain, Paul K.
AU - Bajema, Kristina L.
AU - Dowdy, David
AU - Dheda, Keertan
AU - Naidoo, Kogieleum
AU - Schumacher, Samuel G.
AU - Ma, Shuyi
AU - Meermeier, Erin
AU - Lewinsohn, David M.
AU - Sherman, David R.
N1 - Publisher Copyright:
© 2018, American Society for Microbiology. All rights reserved.
PY - 2018/10
Y1 - 2018/10
N2 - Tuberculosis (TB) is the leading infectious cause of mortality worldwide, due in part to a limited understanding of its clinical pathogenic spectrum of infection and disease. Historically, scientific research, diagnostic testing, and drug treatment have focused on addressing one of two disease states: latent TB infection or active TB disease. Recent research has clearly demonstrated that human TB infection, from latent infection to active disease, exists within a continuous spectrum of metabolic bacterial activity and antagonistic immunological responses. This revised understanding leads us to propose two additional clinical states: incipient and subclinical TB. The recognition of incipient and subclinical TB, which helps divide latent and active TB along the clinical disease spectrum, provides opportunities for the devel-opment of diagnostic and therapeutic interventions to prevent progression to active TB disease and transmission of TB bacilli. In this report, we review the current understanding of the pathogenesis, immunology, clinical epidemiology, diagnosis, treatment, and prevention of both incipient and subclinical TB, two emerging clinical states of an ancient bacterium.
AB - Tuberculosis (TB) is the leading infectious cause of mortality worldwide, due in part to a limited understanding of its clinical pathogenic spectrum of infection and disease. Historically, scientific research, diagnostic testing, and drug treatment have focused on addressing one of two disease states: latent TB infection or active TB disease. Recent research has clearly demonstrated that human TB infection, from latent infection to active disease, exists within a continuous spectrum of metabolic bacterial activity and antagonistic immunological responses. This revised understanding leads us to propose two additional clinical states: incipient and subclinical TB. The recognition of incipient and subclinical TB, which helps divide latent and active TB along the clinical disease spectrum, provides opportunities for the devel-opment of diagnostic and therapeutic interventions to prevent progression to active TB disease and transmission of TB bacilli. In this report, we review the current understanding of the pathogenesis, immunology, clinical epidemiology, diagnosis, treatment, and prevention of both incipient and subclinical TB, two emerging clinical states of an ancient bacterium.
KW - Mycobacterium tuberculosis
KW - Tuberculosis
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U2 - 10.1128/CMR.00021-18
DO - 10.1128/CMR.00021-18
M3 - Review article
C2 - 30021818
AN - SCOPUS:85052144789
SN - 0893-8512
VL - 31
JO - Clinical Microbiology Reviews
JF - Clinical Microbiology Reviews
IS - 4
M1 - e00021-18
ER -