Understanding the interaction between cytomegalovirus and tuberculosis in children: The way forward.

Over 1 million children develop tuberculosis (TB) each year, with a quarter dying. Multiple factors impact the risk of a child being exposed to Mycobacterium tuberculosis (Mtb), the risk of progressing to TB disease, and the risk of dying. However, an emerging body of evidence suggests that coinfect...

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Main Authors: Laura Olbrich, Lisa Stockdale, Robindra Basu Roy, Rinn Song, Luka Cicin-Sain, Elizabeth Whittaker, Andrew J Prendergast, Helen Fletcher, James A Seddon
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2021-12-01
Series:PLoS Pathogens
Online Access:https://journals.plos.org/plospathogens/article/file?id=10.1371/journal.ppat.1010061&type=printable
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author Laura Olbrich
Lisa Stockdale
Robindra Basu Roy
Rinn Song
Luka Cicin-Sain
Elizabeth Whittaker
Andrew J Prendergast
Helen Fletcher
James A Seddon
author_facet Laura Olbrich
Lisa Stockdale
Robindra Basu Roy
Rinn Song
Luka Cicin-Sain
Elizabeth Whittaker
Andrew J Prendergast
Helen Fletcher
James A Seddon
author_sort Laura Olbrich
collection DOAJ
description Over 1 million children develop tuberculosis (TB) each year, with a quarter dying. Multiple factors impact the risk of a child being exposed to Mycobacterium tuberculosis (Mtb), the risk of progressing to TB disease, and the risk of dying. However, an emerging body of evidence suggests that coinfection with cytomegalovirus (CMV), a ubiquitous herpes virus, impacts the host response to Mtb, potentially influencing the probability of disease progression, type of TB disease, performance of TB diagnostics, and disease outcome. It is also likely that infection with Mtb impacts CMV pathogenesis. Our current understanding of the burden of these 2 diseases in children, their immunological interactions, and the clinical consequence of coinfection is incomplete. It is also unclear how potential interventions might affect disease progression and outcome for TB or CMV. This article reviews the epidemiological, clinical, and immunological literature on CMV and TB in children and explores how the 2 pathogens interact, while also considering the impact of HIV on this relationship. It outlines areas of research uncertainty and makes practical suggestions as to potential studies that might address these gaps. Current research is hampered by inconsistent definitions, study designs, and laboratory practices, and more consistency and collaboration between researchers would lead to greater clarity. The ambitious targets outlined in the World Health Organization End TB Strategy will only be met through a better understanding of all aspects of child TB, including the substantial impact of coinfections.
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spelling doaj-art-132c6a75121f4597a9dcda94f22de6cd2025-08-20T02:22:26ZengPublic Library of Science (PLoS)PLoS Pathogens1553-73661553-73742021-12-011712e101006110.1371/journal.ppat.1010061Understanding the interaction between cytomegalovirus and tuberculosis in children: The way forward.Laura OlbrichLisa StockdaleRobindra Basu RoyRinn SongLuka Cicin-SainElizabeth WhittakerAndrew J PrendergastHelen FletcherJames A SeddonOver 1 million children develop tuberculosis (TB) each year, with a quarter dying. Multiple factors impact the risk of a child being exposed to Mycobacterium tuberculosis (Mtb), the risk of progressing to TB disease, and the risk of dying. However, an emerging body of evidence suggests that coinfection with cytomegalovirus (CMV), a ubiquitous herpes virus, impacts the host response to Mtb, potentially influencing the probability of disease progression, type of TB disease, performance of TB diagnostics, and disease outcome. It is also likely that infection with Mtb impacts CMV pathogenesis. Our current understanding of the burden of these 2 diseases in children, their immunological interactions, and the clinical consequence of coinfection is incomplete. It is also unclear how potential interventions might affect disease progression and outcome for TB or CMV. This article reviews the epidemiological, clinical, and immunological literature on CMV and TB in children and explores how the 2 pathogens interact, while also considering the impact of HIV on this relationship. It outlines areas of research uncertainty and makes practical suggestions as to potential studies that might address these gaps. Current research is hampered by inconsistent definitions, study designs, and laboratory practices, and more consistency and collaboration between researchers would lead to greater clarity. The ambitious targets outlined in the World Health Organization End TB Strategy will only be met through a better understanding of all aspects of child TB, including the substantial impact of coinfections.https://journals.plos.org/plospathogens/article/file?id=10.1371/journal.ppat.1010061&type=printable
spellingShingle Laura Olbrich
Lisa Stockdale
Robindra Basu Roy
Rinn Song
Luka Cicin-Sain
Elizabeth Whittaker
Andrew J Prendergast
Helen Fletcher
James A Seddon
Understanding the interaction between cytomegalovirus and tuberculosis in children: The way forward.
PLoS Pathogens
title Understanding the interaction between cytomegalovirus and tuberculosis in children: The way forward.
title_full Understanding the interaction between cytomegalovirus and tuberculosis in children: The way forward.
title_fullStr Understanding the interaction between cytomegalovirus and tuberculosis in children: The way forward.
title_full_unstemmed Understanding the interaction between cytomegalovirus and tuberculosis in children: The way forward.
title_short Understanding the interaction between cytomegalovirus and tuberculosis in children: The way forward.
title_sort understanding the interaction between cytomegalovirus and tuberculosis in children the way forward
url https://journals.plos.org/plospathogens/article/file?id=10.1371/journal.ppat.1010061&type=printable
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