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Cited by 166Tuberculosis Research and EpidemiologyInfectious Diseases and TuberculosisDiagnosis and treatment of tuberculosis

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

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Migliori, Giovanni Battista, Ong, Catherine W.M., Petrone, Linda, D'Ambrosio, Lia, Centis, Rosella, Goletti, Delia·2021·Breathe
DOI 10.1183/20734735.0079-2021PMC PMC8753649
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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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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.
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.CC BY-NC · PubMed Central

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Metadata

Authors
Migliori, G. B., Ong, C. W. M., Petrone, L., D'Ambrosio, L., Centis, R., & Goletti, D.
Affiliations
  • Istituti Clinici Scientifici Maugeri (IT)
  • National University of Singapore (SG)
  • Istituto Nazionale per le Malattie Infettive Lazzaro Spallanzani (IT)
Corresponding author
Migliori, Giovanni Battista
ORCID
Venue
Breathe
Publisher
European Respiratory Society (ERS)
Published
2021-09
Volume
17
Issue
3
Pages
210079
ISSN
  • 1810-6838 (ISSN-L)
  • 2073-4735
DOI
10.1183/20734735.0079-2021
PMC
PMC8753649
OpenAlex
W3196428738
Cited by
166
References
63
Citations by year
2026: 24 · 2025: 43 · 2024: 33 · 2023: 38 · 2022: 25 · 2021: 3
FWCI
2.90
Type
journal article
Language
en
Open access
Licence
Locations
  • Breathe (publishedVersion, cc-by-nc)
  • PubMed Central (publishedVersion, cc-by-nc)
  • PubMed (publishedVersion)
  • National University of Singapore (submittedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
Funders
Ministero della Salute (Linea 4)
Topics
  • Health Sciences › Medicine › Infectious Diseases › Tuberculosis Research and Epidemiology
  • Health Sciences › Medicine › Infectious Diseases › Infectious Diseases and Tuberculosis
  • Health Sciences › Medicine › Infectious Diseases › Diagnosis and treatment of tuberculosis
Keywords
tuberculosis infection, latent tuberculosis infection, subclinical tuberculosis, Mycobacterium tuberculosis, tuberculin skin test, interferon-gamma release assay, tuberculosis transmission, tuberculosis prevention, tuberculosis diagnosis, tuberculosis treatment, public health policy

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