Prevalence of abnormal radiological findings in health care workers with latent tuberculosis infection and correlations with T cell immune response.

<h4>Background</h4>More than half of all health care workers (HCWs) in high TB-incidence, low and middle income countries are latently infected with tuberculosis (TB). We determined radiological lesions in a cohort of HCWs with latent TB infection (LTBI) in India, and determined their as...

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Main Authors: Rajnish Joshi, Samir Patil, Shriprakash Kalantri, Kevin Schwartzman, Dick Menzies, Madhukar Pai
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2007-08-01
Series:PLoS ONE
Online Access:https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0000805&type=printable
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author Rajnish Joshi
Samir Patil
Shriprakash Kalantri
Kevin Schwartzman
Dick Menzies
Madhukar Pai
author_facet Rajnish Joshi
Samir Patil
Shriprakash Kalantri
Kevin Schwartzman
Dick Menzies
Madhukar Pai
author_sort Rajnish Joshi
collection DOAJ
description <h4>Background</h4>More than half of all health care workers (HCWs) in high TB-incidence, low and middle income countries are latently infected with tuberculosis (TB). We determined radiological lesions in a cohort of HCWs with latent TB infection (LTBI) in India, and determined their association with demographic, occupational and T-cell immune response variables.<h4>Methodology</h4>We obtained chest radiographs of HCWs who had undergone tuberculin skin test (TST) and QuantiFERON-TB Gold In Tube (QFT), an interferon-gamma release assay, in a previous cross-sectional study, and were diagnosed to have LTBI because they were positive by either TST or QFT, but had no evidence of clinical disease. Two observers independently interpreted these radiographs using a standardized data form and any discordance between them resolved by a third observer. The radiological diagnostic categories (normal, suggestive of inactive TB, and suggestive of active TB) were compared with results of TST, QFT assay, demographic, and occupational covariates.<h4>Results</h4>A total of 330 HCWs with positive TST or QFT underwent standard chest radiography. Of these 330, 113 radiographs (34.2%) were finally classified as normal, 206 (62.4%) had lesions suggestive of inactive TB, and 11 (3.4%) had features suggestive of active TB. The mean TST indurations and interferon-gamma levels in the HCWs in these three categories were not significantly different. None of the demographic or occupational covariates was associated with prevalence of inactive TB lesions on chest radiography.<h4>Conclusion/significance</h4>In a high TB incidence setting, nearly two-thirds of HCWs with latent TB infection had abnormal radiographic findings, and these findings had no clear correlation with T cell immune responses. Further studies are needed to verify these findings and to identify the causes and prognosis of radiologic abnormalities in health care workers.
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spelling doaj-art-ead73bfccaea4605849b9698a370bac02025-08-20T03:55:22ZengPublic Library of Science (PLoS)PLoS ONE1932-62032007-08-0128e80510.1371/journal.pone.0000805Prevalence of abnormal radiological findings in health care workers with latent tuberculosis infection and correlations with T cell immune response.Rajnish JoshiSamir PatilShriprakash KalantriKevin SchwartzmanDick MenziesMadhukar Pai<h4>Background</h4>More than half of all health care workers (HCWs) in high TB-incidence, low and middle income countries are latently infected with tuberculosis (TB). We determined radiological lesions in a cohort of HCWs with latent TB infection (LTBI) in India, and determined their association with demographic, occupational and T-cell immune response variables.<h4>Methodology</h4>We obtained chest radiographs of HCWs who had undergone tuberculin skin test (TST) and QuantiFERON-TB Gold In Tube (QFT), an interferon-gamma release assay, in a previous cross-sectional study, and were diagnosed to have LTBI because they were positive by either TST or QFT, but had no evidence of clinical disease. Two observers independently interpreted these radiographs using a standardized data form and any discordance between them resolved by a third observer. The radiological diagnostic categories (normal, suggestive of inactive TB, and suggestive of active TB) were compared with results of TST, QFT assay, demographic, and occupational covariates.<h4>Results</h4>A total of 330 HCWs with positive TST or QFT underwent standard chest radiography. Of these 330, 113 radiographs (34.2%) were finally classified as normal, 206 (62.4%) had lesions suggestive of inactive TB, and 11 (3.4%) had features suggestive of active TB. The mean TST indurations and interferon-gamma levels in the HCWs in these three categories were not significantly different. None of the demographic or occupational covariates was associated with prevalence of inactive TB lesions on chest radiography.<h4>Conclusion/significance</h4>In a high TB incidence setting, nearly two-thirds of HCWs with latent TB infection had abnormal radiographic findings, and these findings had no clear correlation with T cell immune responses. Further studies are needed to verify these findings and to identify the causes and prognosis of radiologic abnormalities in health care workers.https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0000805&type=printable
spellingShingle Rajnish Joshi
Samir Patil
Shriprakash Kalantri
Kevin Schwartzman
Dick Menzies
Madhukar Pai
Prevalence of abnormal radiological findings in health care workers with latent tuberculosis infection and correlations with T cell immune response.
PLoS ONE
title Prevalence of abnormal radiological findings in health care workers with latent tuberculosis infection and correlations with T cell immune response.
title_full Prevalence of abnormal radiological findings in health care workers with latent tuberculosis infection and correlations with T cell immune response.
title_fullStr Prevalence of abnormal radiological findings in health care workers with latent tuberculosis infection and correlations with T cell immune response.
title_full_unstemmed Prevalence of abnormal radiological findings in health care workers with latent tuberculosis infection and correlations with T cell immune response.
title_short Prevalence of abnormal radiological findings in health care workers with latent tuberculosis infection and correlations with T cell immune response.
title_sort prevalence of abnormal radiological findings in health care workers with latent tuberculosis infection and correlations with t cell immune response
url https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0000805&type=printable
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