Author:
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-
1.
WHO, 2020. Global Tuberculosis Report 2020. Geneva, Switzerland: World Health Organization.
-
2.
WHO, 2019. Latent tuberculosis infection: updated and consolidated guidelines for programmatic management. Latent Tuberculosis Infection 38: 1–78.
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3.
Sterling TR et al., 2020. Guidelines for the treatment of latent tuberculosis infection: recommendations from the National Tuberculosis Controllers Association and CDC, 2020. MMWR Recomm Rep 2020: 1–11.
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4.
Drain PK et al., 2018. Incipient and subclinical tuberculosis: a clinical review of early stages and progression of infection. Clin Microbiol Rev 31: 1–24.
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5.
Pai M et al.2016. Tuberculosis. Nat Rev Dis Prim 2: 1–19.
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6.
Behr MA , Edelstein PH , Ramakrishnan L , 2018. Revisiting the timetable of tuberculosis. BMJ 362: 1–10.
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7.
Cadena AM , Fortune SM , Flynn JL , 2017. Heterogeneity in tuberculosis. Nat Rev Immunol 17: 691–702.
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8.
Salgame P , Geadas C , Collins L , Jones-López E , Ellner JJ , 2015. Latent tuberculosis infection - revisiting and revising concepts. Tuberculosis (Edinb) 95: 373–384.
-
9.
Tiemersma EW , van der Werf MJ , Borgdorff MW , Williams BG , Nagelkerke NJD , 2011. Natural history of tuberculosis: duration and fatality of untreated pulmonary tuberculosis in HIV negative patients: a systematic review. PLoS One 6: 1–11.
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10.
POULSEN , 1950. Some clinical features of tuberculosis. 1. Incubation period. Acta Tuberc Pneumol Scand 24: 311–346.
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11.
Wallgren A , 1948. The time-table of tuberculosis. Tubercle. 245–251. https://doi.org/10.1016/S0041-3879(48)80033-4.
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12.
Dye C , Watt CJ , Bleed DM , Hosseini SM , Raviglione MC , 2005. Evolution of tuberculosis control and prospects for reducing tuberculosis incidence, prevalence, and deaths globally. JAMA 293: 2767–2775.
-
13.
Dale KD , Trauer JM , Dodd PJ , Houben RMGJ , Denholm JT , 2020. Estimating long-term tuberculosis reactivation rates in Australian migrants. Clin Infect Dis 70: 2111–2118.
-
14.
Dobbs TE , Webb RM , 2017. Chemotherapy of tuberculosis. Microbiol Spectr 5: 2–5.
-
15.
Yoo JE et al., 2021. Diabetes status and association with risk of tuberculosis among Korean adults. JAMA Netw Open 4: 1–11.
-
16.
Schwander S , Dheda K , 2011. Human lung immunity against Mycobacterium tuberculosis: insights into pathogenesis and protection. Am J Respir Crit Care Med 183: 696–707.
-
17.
Barry CE III et al., 2009. The spectrum of latent tuberculosis: rethinking the goals of prophylaxis. Nat Rev Microbiol 7: 845–855.
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18.
Simmons JD et al., 2018. Immunological mechanisms of human resistance to persistent Mycobacterium tuberculosis infection. Nat Rev Immunol 18: 575–589.
-
19.
Morrison J , Pai M , Hopewell PC , 2008. Tuberculosis and latent tuberculosis infection in close contacts of people with pulmonary tuberculosis in low-income and middle-income countries: a systematic review and meta-analysis. Lancet Infect Dis 8: 359–368.
-
20.
Zwick ED , Pepperell CS , 2020. Tuberculosis sanatorium treatment at the advent of the chemotherapy era. BMC Infect Dis 20: 1–11.
-
21.
Tattersal WH , 1947. The survival of sputum-positive consumptives; a study of 1,192 cases in a county borough between 1914 and 1940. Tubercle 28: 107–114.
-
22.
Karat AS et al., 2016. Autopsy prevalence of tuberculosis and other potentially treatable infections among adults with advanced HIV enrolled in out-patient care in South Africa. PLoS One 11: 1–16.
-
23.
Esmail H et al., 2016. Characterization of progressive HIV-associated tuberculosis using 2-deoxy-2-[18 F]fluoro-D-glucose positron emission and computed tomography. Nat Med 22: 1090–1093.
-
24.
Millington KA , Gooding S , Hinks TSC , Reynolds DJM , Lalvani A , 2010. Mycobacterium tuberculosis-specific cellular immune profiles suggest bacillary persistence decades after spontaneous cure in untreated tuberculosis. J Infect Dis 202: 1685–1689.
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Case Report: Tuberculosis Autoregression after Minimal Treatment and Review of the Literature
Chelsea Walter
Chelsea Walter
Section of Infectious Diseases, Department of Medicine, Boston Medical Center and Boston University School of Medicine, Boston, Massachusetts;
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Carlos Acuña-Villaorduna
Carlos Acuña-Villaorduna
Section of Infectious Diseases, Department of Medicine, Boston Medical Center and Boston University School of Medicine, Boston, Massachusetts;
Lemuel Shattuck Hospital, Department of Public Health, Boston, Massachusetts;
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Lemuel Shattuck Hospital, Department of Public Health, Boston, Massachusetts;
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Natasha S. Hochberg
Natasha S. Hochberg
Section of Infectious Diseases, Department of Medicine, Boston Medical Center and Boston University School of Medicine, Boston, Massachusetts;
Department of Epidemiology, Boston University School of Public Health, Boston, Massachusetts
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Department of Epidemiology, Boston University School of Public Health, Boston, Massachusetts
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Pranay Sinha
Pranay Sinha
Section of Infectious Diseases, Department of Medicine, Boston Medical Center and Boston University School of Medicine, Boston, Massachusetts;
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ABSTRACT.
Mycobacterium tuberculosis (Mtb) is a complex pathogen causing multiple possible disease states in its host including latency, active disease, and elimination. While there is reasonable indirect evidence of elimination of tuberculosis (TB) in the absence of treatment, direct reports of autoregression are rare. We report a case of smear-negative, polymerase chain reaction (PCR)-positive TB disease regression in the absence of therapy due to severe adverse effects from antimycobacterial drugs. Indirect reports of TB autoregression, or self-cure, in the literature are reviewed, and an updated framework for conceptualizing Mtb infection is discussed.
Author Notes
Financial support: This work was supported by the National Institutes of Health (Grant no. 5T32AI052074-13 to PS); the Burroughs Wellcome/ASTMH Postdoctoral fellowship to PS; US Civilian Research and Development Foundation (Grant no. USB-31150-XX-13 to NSH); the National Science Foundation (cooperative agreement OISE-9531011 to NSH), with federal funds from the Government of India’s Department of Biotechnology, the Indian Council of Medical Research, the National Institutes of Health, the National Institute of Allergy and Infectious Diseases, and the Office of AIDS Research and distributed in part by CRDF Global; grant from the Warren Alpert Foundation and Boston University School of Medicine (to NSH); the Clinical and Translational Sciences Institute (Grant no. 1UL1TR001430 to NSH); and funding from Boston University Foundation India (to NSH). The funders had no role in study design, analysis, or reporting.
Authors’ addresses: Chelsea Walter and Pranay Sinha, Section of Infectious Diseases, Department of Medicine, Boston Medical Center and Boston University School of Medicine, Boston, MA, E-mails: waltercr7@gmail.com and pranay.sinha@bmc.org. Carlos Acuña-Villaorduna, Section of Infectious Diseases, Department of Medicine, Boston Medical Center and Boston University School of Medicine, Boston, MA, and Lemuel Shattuck Hospital, Department of Public Health, Boston, MA, E-mail: carlos.acuna-villaorduna@bmc.org. Natasha S. Hochberg, Section of Infectious Diseases, Department of Medicine, Boston Medical Center and Boston University School of Medicine, Boston, MA, and Department of Epidemiology, Boston University School of Public Health, Boston, MA, E-mail: nhoch@bu.edu.
ProCite
RefWorks
Reference Manager
BibTeX
Zotero
EndNote
-
1.
WHO, 2020. Global Tuberculosis Report 2020. Geneva, Switzerland: World Health Organization.
-
2.
WHO, 2019. Latent tuberculosis infection: updated and consolidated guidelines for programmatic management. Latent Tuberculosis Infection 38: 1–78.
-
3.
Sterling TR et al., 2020. Guidelines for the treatment of latent tuberculosis infection: recommendations from the National Tuberculosis Controllers Association and CDC, 2020. MMWR Recomm Rep 2020: 1–11.
-
4.
Drain PK et al., 2018. Incipient and subclinical tuberculosis: a clinical review of early stages and progression of infection. Clin Microbiol Rev 31: 1–24.
-
5.
Pai M et al.2016. Tuberculosis. Nat Rev Dis Prim 2: 1–19.
-
6.
Behr MA , Edelstein PH , Ramakrishnan L , 2018. Revisiting the timetable of tuberculosis. BMJ 362: 1–10.
-
7.
Cadena AM , Fortune SM , Flynn JL , 2017. Heterogeneity in tuberculosis. Nat Rev Immunol 17: 691–702.
-
8.
Salgame P , Geadas C , Collins L , Jones-López E , Ellner JJ , 2015. Latent tuberculosis infection - revisiting and revising concepts. Tuberculosis (Edinb) 95: 373–384.
-
9.
Tiemersma EW , van der Werf MJ , Borgdorff MW , Williams BG , Nagelkerke NJD , 2011. Natural history of tuberculosis: duration and fatality of untreated pulmonary tuberculosis in HIV negative patients: a systematic review. PLoS One 6: 1–11.
-
10.
POULSEN , 1950. Some clinical features of tuberculosis. 1. Incubation period. Acta Tuberc Pneumol Scand 24: 311–346.
-
11.
Wallgren A , 1948. The time-table of tuberculosis. Tubercle. 245–251. https://doi.org/10.1016/S0041-3879(48)80033-4.
-
12.
Dye C , Watt CJ , Bleed DM , Hosseini SM , Raviglione MC , 2005. Evolution of tuberculosis control and prospects for reducing tuberculosis incidence, prevalence, and deaths globally. JAMA 293: 2767–2775.
-
13.
Dale KD , Trauer JM , Dodd PJ , Houben RMGJ , Denholm JT , 2020. Estimating long-term tuberculosis reactivation rates in Australian migrants. Clin Infect Dis 70: 2111–2118.
-
14.
Dobbs TE , Webb RM , 2017. Chemotherapy of tuberculosis. Microbiol Spectr 5: 2–5.
-
15.
Yoo JE et al., 2021. Diabetes status and association with risk of tuberculosis among Korean adults. JAMA Netw Open 4: 1–11.
-
16.
Schwander S , Dheda K , 2011. Human lung immunity against Mycobacterium tuberculosis: insights into pathogenesis and protection. Am J Respir Crit Care Med 183: 696–707.
-
17.
Barry CE III et al., 2009. The spectrum of latent tuberculosis: rethinking the goals of prophylaxis. Nat Rev Microbiol 7: 845–855.
-
18.
Simmons JD et al., 2018. Immunological mechanisms of human resistance to persistent Mycobacterium tuberculosis infection. Nat Rev Immunol 18: 575–589.
-
19.
Morrison J , Pai M , Hopewell PC , 2008. Tuberculosis and latent tuberculosis infection in close contacts of people with pulmonary tuberculosis in low-income and middle-income countries: a systematic review and meta-analysis. Lancet Infect Dis 8: 359–368.
-
20.
Zwick ED , Pepperell CS , 2020. Tuberculosis sanatorium treatment at the advent of the chemotherapy era. BMC Infect Dis 20: 1–11.
-
21.
Tattersal WH , 1947. The survival of sputum-positive consumptives; a study of 1,192 cases in a county borough between 1914 and 1940. Tubercle 28: 107–114.
-
22.
Karat AS et al., 2016. Autopsy prevalence of tuberculosis and other potentially treatable infections among adults with advanced HIV enrolled in out-patient care in South Africa. PLoS One 11: 1–16.
-
23.
Esmail H et al., 2016. Characterization of progressive HIV-associated tuberculosis using 2-deoxy-2-[18 F]fluoro-D-glucose positron emission and computed tomography. Nat Med 22: 1090–1093.
-
24.
Millington KA , Gooding S , Hinks TSC , Reynolds DJM , Lalvani A , 2010. Mycobacterium tuberculosis-specific cellular immune profiles suggest bacillary persistence decades after spontaneous cure in untreated tuberculosis. J Infect Dis 202: 1685–1689.
| Past two years | Past Year | Past 30 Days | |
|---|---|---|---|
| Abstract Views | 6806 | 3894 | 17 |
| Full Text Views | 94 | 55 | 0 |
| PDF Downloads | 56 | 33 | 0 |