Pulmonary tuberculosis: virulence of Mycobacterium africanum and relevance in HIV co-infection.
Identifieur interne : 000B33 ( Main/Exploration ); précédent : 000B32; suivant : 000B34Pulmonary tuberculosis: virulence of Mycobacterium africanum and relevance in HIV co-infection.
Auteurs : Christian G. Meyer [Allemagne] ; Genevieve Scarisbrick ; Stefan Niemann ; Edmund N L. Browne ; Margaret Amanua Chinbuah ; John Gyapong ; Ivy Osei ; Ellis Owusu-Dabo ; Tanja Kubica ; Sabine Rüsch-Gerdes ; Thorsten Thye ; Rolf D. HorstmannSource :
- Tuberculosis (Edinburgh, Scotland) [ 1873-281X ] ; 2008.
Descripteurs français
- KwdFr :
- Adulte, Expectoration (immunologie), Femelle, Ghana, Humains, Infections opportunistes liées au SIDA (génétique), Infections opportunistes liées au SIDA (immunologie), Infections opportunistes liées au SIDA (transmission), Infections à VIH (génétique), Infections à VIH (immunologie), Infections à VIH (transmission), Mycobacterium (), Mycobacterium (pathogénicité), Mâle, Radiographie thoracique, Tuberculose multirésistante (génétique), Tuberculose pulmonaire (diagnostic), Tuberculose pulmonaire (génétique), Tuberculose pulmonaire (immunologie), Tuberculose pulmonaire (transmission), Virulence.
- MESH :
- diagnostic : Tuberculose pulmonaire.
- génétique : Infections opportunistes liées au SIDA, Infections à VIH, Tuberculose multirésistante, Tuberculose pulmonaire.
- immunologie : Expectoration, Infections opportunistes liées au SIDA, Infections à VIH, Tuberculose pulmonaire.
- pathogénicité : Mycobacterium.
- Adulte, Femelle, Ghana, Humains, Infections opportunistes liées au SIDA, Infections à VIH, Mycobacterium, Mâle, Radiographie thoracique, Tuberculose pulmonaire, Virulence.
- Wicri :
- geographic : Ghana.
English descriptors
- KwdEn :
- AIDS-Related Opportunistic Infections (genetics), AIDS-Related Opportunistic Infections (immunology), AIDS-Related Opportunistic Infections (transmission), Adult, Female, Ghana, HIV Infections (genetics), HIV Infections (immunology), HIV Infections (transmission), Humans, Male, Mycobacterium (classification), Mycobacterium (pathogenicity), Radiography, Thoracic, Sputum (immunology), Tuberculosis, Multidrug-Resistant (genetics), Tuberculosis, Pulmonary (diagnosis), Tuberculosis, Pulmonary (genetics), Tuberculosis, Pulmonary (immunology), Tuberculosis, Pulmonary (transmission), Virulence.
- MESH :
- geographic : Ghana.
- classification : Mycobacterium.
- diagnosis : Tuberculosis, Pulmonary.
- genetics : AIDS-Related Opportunistic Infections, HIV Infections, Tuberculosis, Multidrug-Resistant, Tuberculosis, Pulmonary.
- immunology : AIDS-Related Opportunistic Infections, HIV Infections, Sputum, Tuberculosis, Pulmonary.
- pathogenicity : Mycobacterium.
- transmission : AIDS-Related Opportunistic Infections, HIV Infections, Tuberculosis, Pulmonary.
- Adult, Female, Humans, Male, Radiography, Thoracic, Virulence.
Abstract
Although Mycobacterium africanum is being isolated in a significant proportion of cases of pulmonary tuberculosis in West Africa, its pathogenic potential remains a matter of discussion. Recent reports leave the question of whether M. africanum causes more severe pathology than M. tuberculosis or resembles opportunistic pathogens and might gain importance in the course of the HIV pandemic. Patients with pulmonary tuberculosis associated with M. africanum (n=556) and M. tuberculosis (n=1350) were studied in Ghana, West Africa, and compared regarding self-reported signs and symptoms, chest radiography, HIV status, mycobacterial drug resistance and mycobacterial clustering as determined by spoligotyping and IS6110 fingerprints. The rate of M. africanum infections was similar in HIV-positive (27%) and HIV-negative (30%) patients. M. africanum clustered less than M. tuberculosis (21% vs 79%; OR, 0.38; 95% CI, 0.3-0.5; p<0.001) corresponding to its lower prevalence (29% vs 70%). Clinically and radiographically, no significant differences were found except that M. africanum caused lower-lobe disease less frequently than M. tuberculosis (OR, 0.39; 95% CI, 0.2-0.7; Pc=0.01), whereby this association applied to HIV-negative patients only. No difference in virulence, as assessed by the severity of radiological presentation, was found when the two M. africanum subtypes West African 1 and West African 2 were compared. In the population studied, M. africanum closely resembled M. tuberculosis in pathology and cannot be considered an opportunistic pathogen.
DOI: 10.1016/j.tube.2008.05.004
PubMed: 18590979
Affiliations:
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Recent reports leave the question of whether M. africanum causes more severe pathology than M. tuberculosis or resembles opportunistic pathogens and might gain importance in the course of the HIV pandemic. Patients with pulmonary tuberculosis associated with M. africanum (n=556) and M. tuberculosis (n=1350) were studied in Ghana, West Africa, and compared regarding self-reported signs and symptoms, chest radiography, HIV status, mycobacterial drug resistance and mycobacterial clustering as determined by spoligotyping and IS6110 fingerprints. The rate of M. africanum infections was similar in HIV-positive (27%) and HIV-negative (30%) patients. M. africanum clustered less than M. tuberculosis (21% vs 79%; OR, 0.38; 95% CI, 0.3-0.5; p<0.001) corresponding to its lower prevalence (29% vs 70%). Clinically and radiographically, no significant differences were found except that M. africanum caused lower-lobe disease less frequently than M. tuberculosis (OR, 0.39; 95% CI, 0.2-0.7; Pc=0.01), whereby this association applied to HIV-negative patients only. No difference in virulence, as assessed by the severity of radiological presentation, was found when the two M. africanum subtypes West African 1 and West African 2 were compared. In the population studied, M. africanum closely resembled M. tuberculosis in pathology and cannot be considered an opportunistic pathogen.</div></front></TEI><affiliations><list><country><li>Allemagne</li></country><region><li>Hambourg</li></region><settlement><li>Hambourg</li></settlement></list><tree><noCountry><name sortKey="Browne, Edmund N L" sort="Browne, Edmund N L" uniqKey="Browne E" first="Edmund N L" last="Browne">Edmund N L. Browne</name><name sortKey="Chinbuah, Margaret Amanua" sort="Chinbuah, Margaret Amanua" uniqKey="Chinbuah M" first="Margaret Amanua" last="Chinbuah">Margaret Amanua Chinbuah</name><name sortKey="Gyapong, John" sort="Gyapong, John" uniqKey="Gyapong J" first="John" last="Gyapong">John Gyapong</name><name sortKey="Horstmann, Rolf D" sort="Horstmann, Rolf D" uniqKey="Horstmann R" first="Rolf D" last="Horstmann">Rolf D. Horstmann</name><name sortKey="Kubica, Tanja" sort="Kubica, Tanja" uniqKey="Kubica T" first="Tanja" last="Kubica">Tanja Kubica</name><name sortKey="Niemann, Stefan" sort="Niemann, Stefan" uniqKey="Niemann S" first="Stefan" last="Niemann">Stefan Niemann</name><name sortKey="Osei, Ivy" sort="Osei, Ivy" uniqKey="Osei I" first="Ivy" last="Osei">Ivy Osei</name><name sortKey="Owusu Dabo, Ellis" sort="Owusu Dabo, Ellis" uniqKey="Owusu Dabo E" first="Ellis" last="Owusu-Dabo">Ellis Owusu-Dabo</name><name sortKey="Rusch Gerdes, Sabine" sort="Rusch Gerdes, Sabine" uniqKey="Rusch Gerdes S" first="Sabine" last="Rüsch-Gerdes">Sabine Rüsch-Gerdes</name><name sortKey="Scarisbrick, Genevieve" sort="Scarisbrick, Genevieve" uniqKey="Scarisbrick G" first="Genevieve" last="Scarisbrick">Genevieve Scarisbrick</name><name sortKey="Thye, Thorsten" sort="Thye, Thorsten" uniqKey="Thye T" first="Thorsten" last="Thye">Thorsten Thye</name></noCountry><country name="Allemagne"><region name="Hambourg"><name sortKey="Meyer, Christian G" sort="Meyer, Christian G" uniqKey="Meyer C" first="Christian G" last="Meyer">Christian G. 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