• 제목/요약/키워드: latent infection

검색결과 164건 처리시간 0.034초

Usefulness of interferon-γ release assay for the diagnosis of latent tuberculosis infection in young children

  • Yun, Ki Wook;Kim, Young Kwang;Kim, Hae Ryun;Lee, Mi Kyung;Lim, In Seok
    • Clinical and Experimental Pediatrics
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    • 제59권6호
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    • pp.256-261
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    • 2016
  • Purpose: Latent tuberculosis infection (LTBI) in young children may progress to severe active tuberculosis (TB) disease and serve as a reservoir for future transmission of TB disease. There are limited data on interferon-${\gamma}$ release assay (IGRA) performance in young children, which our research aims to address by investigating the usefulness of IGRA for the diagnosis of LTBI. Methods: We performed a tuberculin skin test (TST) and IGRA on children who were younger than 18 years and were admitted to Chung-Ang University Hospital during May 2011-June 2015. Blood samples for IGRA were collected, processed, and interpreted according to manufacturer protocol. Results: Among 149 children, 31 (20.8%) and 10 (6.7%) were diagnosed with LTBI and active pulmonary TB, respectively. In subjects lacking contact history with active TB patients, TST and IGRA results were positive in 41.4% (29 of 70) and 12.9% (9 of 70) subjects, respectively. The agreement (kappa) of TST and IGRA was 0.123. The control group, consisting of non-TB-infected subjects, showed no correlation between age and changes in interferon-${\gamma}$ concentration after nil antigen, TB-specific antigen, or mitogen stimulation in IGRAs (P=0.384, P=0.176, and P=0.077, respectively). In serial IGRAs, interferon-${\gamma}$ response to TB antigen increased in IGRA-positive LTBI subjects, but did not change considerably in initially IGRA-negative LTBI or control subjects. Conclusion: The lack of decrease in interferon-${\gamma}$ response in young children indicates that IGRA could be considered for this age group. Serial IGRA tests might accurately diagnose LTBI in children lacking contact history with active TB patients.

우리나라 잠복결핵감염 검진전략의 경제성 분석 (Economic Analysis of Latent Tuberculosis Infection Screening Strategies in Korea)

  • 김상원;강길원;신삼철;송승은
    • 보건행정학회지
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    • 제23권4호
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    • pp.349-357
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    • 2013
  • Background: Although interferon-gamma release assay (IGRA) is now available alternatives to tuberculin skin test (TST) for detection of latent tuberculosis infection (LTBI), the cost of IGRA test is much higher than TST. So economic analysis of LTBI screening strategies have been done in many countries, but there are few reports in Korea. This study examined cost analysis of LTBI screening strategies in Korea. Methods: The economic outcomes were evaluated by five strategies. These were 1) TST alone, 2) IGRA alone, 3) combination of TST and IGRA (TST followed by IGRA) and 4) no testing no prevention, 5) no testing all prevention. Last two strategies were added to compare with three main LTBI screening strategies. Decision analysis model were used to perform economic analysis. A cohort study of Korean Institute of Tuberculosis and the data of published literatures were used to estimate the cost analysis. Results: In a base-case scenario which was assumed that TST specificity was 80%, TST alone was the least expensive strategy. In a alternative scenario which was assumed that TST specificity was 97%, the combination of TST and IGRA was the least expensive strategy. Sensitivity analysis shows that patients adherent rate to LTBI treatment, TST sensitivity, IGRA sensitivity and IGRA specificity did not have a significant impact on the outcomes. Conclusion: In Korea, for the diagnosis of LTBI at the time of child and adolescent, TST alone reduces medical costs compared with IGRA alone or combination of TST and IGRA.

Comparison of Mycobacterium tuberculosis Specific Antigen Stimulation Time for Performing Interferon Gamma mRNA Assay for Detecting Latent Tuberculosis Infection

  • Kim, Sunghyun;Cho, Jang-Eun;Kim, Hyunjung;Lee, Dongsup;Jeon, Bo-Young;Lee, Hyejon;Cho, Sang-Nae;Kim, Young Keun;Lee, Hyeyoung
    • 대한의생명과학회지
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    • 제19권2호
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    • pp.90-97
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    • 2013
  • The tuberculin skin test (TST) and interferon gamma (IFN-${\gamma}$) release assay (IGRA) have been widely used for diagnosis of latent tuberculosis infection (LTBI). In order to overcome limitations of current LTBI diagnostic methods, the development of a novel molecular assay which is able to measure the IFN-${\gamma}$ messenger RNA (mRNA) expression level after stimulation with Mycobacterium tuberculosis (MTB) specific antigen was recently developed. The ability of a molecular assay to detect MTB infection was similar to commercial IGRA however, the optimal incubation time for stimulating IFN-${\gamma}$ was not yet established. Therefore, in this study the direct comparisons of MTB Ag stimulation times (4 and 24 hrs) were performed for diagnosis of MTB infection. Data showed that the coincident rate between QFT-GIT IFN-${\gamma}$ ELISA and IFN-${\gamma}$ RT-PCR (4 hrs) was 88.35% and that of QFT-GIT and IFN-${\gamma}$ RT-PCR (24 hrs) was 70.85%. Based on a receiver operating characteristic (ROC) curve, the 4 hrs-MTB specific Ag stimulation time for IFN-${\gamma}$ RT-PCR had the significant P value, 95% CI value, and AUC (P < 0.0001, 95% CI=0.82 to 1.02, and AUC=0.9214) in comparison with 24 hrs-MTB specific Ag stimulation time (P = 0.009, 95% CI=0.06 to 0.94, and AUC=0.7711). These results show that 4-hr was the most optimal MTB Ag stimulation time for performing IFN-${\gamma}$ RT-PCR. Although semi-quantitative RT-PCR had a few analytical limitations, it might be useful as an alternative molecular diagnostic method for detecting MTB infection.

A Gammaherpesvirus Establishes Persistent Infection in Neuroblastoma Cells

  • Cho, Hye-Jeong;Song, Moon Jung
    • Molecules and Cells
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    • 제37권7호
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    • pp.518-525
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    • 2014
  • Gammaherpesvirus (${\gamma}HV$) infection of the central nervous system (CNS) has been implicated in diverse neurological diseases, and murine ${\gamma}HV$-68 (MHV-68) is known to persist in the brain after cerebral infection. The underlying molecular mechanisms of persistency of virus in the brain are poorly understood. Here, we characterized a unique pattern of MHV-68 persistent infection in neuroblastoma cells. On infection with MHV-68, both murine and human neuroblastoma cells expressed viral lytic proteins and produced virions. However, the infected cells survived productive infection and could be cultured for multiple passages without affecting their cellular growth. Latent infection as well as productive replication was established in these prolonged cultures, and lytic replication was further increased by treatment with lytic inducers. Our results provide a novel system to study persistent infection of ${\gamma}HVs$ in vitro following de novo infection and suggest application of MHV-68 as a potential gene transfer vector to the brain.

임상가를 위한 특집 3 - 헤르페스 감염 (Herpes Infection)

  • 이상신;이석근
    • 대한치과의사협회지
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    • 제48권5호
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    • pp.365-370
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    • 2010
  • Herpes virus family is highly infectious to patients, their families and dentists. The diagnosis of herpes infection is based on the characteristic clinical appearance and the location of the lesions. Herpes Simplex Virus(HSV) usually acquired through direct contact with infected lesions or body fluids, and the prevalence of HSV infection increases progressively from childhood. Primary infections provoke herpetic gingivostomatis typically affects the tongue, lips, gingival, buccal mucosa and palate. Recurrent infections give rise to vesiculo-ulcerative lesions at vermilion border of lip(herpes labialis). In the form of chickenpox, Varicella Zoster Virus(VZV) usually is infected in childhood. VZV spreads in the affected primary afferent nerve to the skin and produces a vesicular rash and pain. Epstein-Barr Virus(EBV) infects B cells and cause infectious mononucleosis. Latent EBV infection has also been implicated in Burkitt lymphoma, nasopharyngeal carcinoma. Cytomegalovirus(CMV) is associated with immune-compromised patient such as organ transplantation and AIDS patients.

인체단핵세포주 THP-1세포에서 Human Cytomegalovirus의 잠복감염과 재활성화 (Latent Infection and Reactivation of Human Cytomegalovirus from Human Monocyte THP-1 Cells)

  • 윤상임;문명숙;이찬희
    • 미생물학회지
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    • 제37권2호
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    • pp.145-150
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    • 2001
  • Human cytomegalovirus (HCMV)의 잠복감염으로 부터의 재활성환느 면역기능이 저하된 사람에게 높은 치사율을 가져오며, 재활성화가 기전의 규명은 매우 중요한 연구과제의 하나이다. HCMV의 잠복감염 부위 중 하나라고 생각되고 있는 인체단핵세포에 대한 HCMV의 영향을 알아보기 위해 여러 분화 단계에 있는 THP-1과 HL-60 세포에 HCMV를 감염시킨 후 생존 세포의 수와 형태적 변화를 살펴보았다. HL-60 세포가 HCMV 감염에 의해 세포 생존이나 형태에 큰 영향을 받지 않는 반면, 좀 더 분화된 세포인 THP-1은 HCMV 감염에 의해 생존 세포의 수가 감소하였고, 형태적 변화도 나타났다. 이러한 형태적 변화는 세포의 응집력의 증가에 의한 것으로 HCMV 감염에 따른 THP-1 세포 표면의 CD11b 발현 증가와 밀접한 관계가 있는 것으로 생각된다. THP-1 세포에 HCMV를 감염시킨 후 잠복감염이 이루어진 것을 확인하고, 세포 분화 유도제인 TPA와 hydrocortisone을 처리하였을 경우 방러스가 재활성화하여 증식하는지 알아보았다. 바이러스 감염 2일째에 분화시킨 THP-1 세포에서는 분화 5일째부터 다량의 바이러스가 검출되었고, 감염 17일째 분화시킨 세포에서는 분화 후 15일째부터 바이러스가 검출됨을 관찰하였다. 이는 HCMV를 THP-1 세포에 감염 후 분화를 시키면 잠복감염해 있는 HCMV가 재활성화 되는 것이라 생각되고, 감복해 있던 기간이 길어질수록 바이러스의 재활성화정도는 지연된다는 것을 의미한다.

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Molecular Survey of Latent Pseudorabies Virus Infection in Nervous Tissues of Slaughtered Pigs by Nested and Real-time PCR

  • Yoon Hyun A;Eo Seong Kug;Aleyas Abi George;Park Seong Ok;Lee John Hwa;Chae Joon Seok;Cho Jeong Gon;Song Hee Jong
    • Journal of Microbiology
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    • 제43권5호
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    • pp.430-436
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    • 2005
  • In this study, the prevalence and quantity of a latent pseudorabies virus (PrV) infection in the nervous tissues of randomly selected pigs was determined via nested and real-time PCR. The nervous tissues, including the trigeminal ganglion (TG), olfactory bulb (OB), and brain stem (BS), were collected from the heads of 40 randomly selected pigs. The majority of the nervous tissues from the selected pigs evidenced a positively amplified band on nested PCR. In particular, nested PCR targeted to the PrV glycoprotein B (gB) gene yielded positive results in all of the BS samples. Nested PCR for either the gE or gG gene produced positive bands in a less number of nervous tissues ($57.5\%$ and $42.5\%$, respectively). Real-time PCR revealed that the examined tissues harbored large copy numbers of latent PrV DNA, ranging between $10^{0.1}\;and\;10^{7.2}(1-1.58{\times}10^7)$ copies per $1{\mu}g$ of genomic DNA. Real-time PCR targeted to the PrV gE gene exhibited an accumulated fluorescence of reporter dye at levels above threshold, thereby indicating a higher prevalence than was observed on the nested PCR ($100\%$ for BS, $92\%$ for OB, and $85\%$ for TG). These results indicate that a large number of farm-grown pigs are latently infected with a field PrV strain with a variety of copy numbers. This result is similar to what was found in association with the human herpes virus.

Prevalence of Latent Tuberculosis Infection among Medical Students in South Korea

  • Jung, Da Ho;Jo, Kyung-Wook;Shim, Tae Sun
    • Tuberculosis and Respiratory Diseases
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    • 제73권4호
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    • pp.219-223
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    • 2012
  • Background: We investigated the prevalence of latent tuberculosis infection (LTBI) among medical students in South Korea. Methods: Students from one medical school, who were in second- or third-year classes before clerkship course, were enrolled for three consecutive years in the study. A standard questionnaire was given to each participant, and tuberculin skin test (TST), QuantiFERON-TB GOLD In-Tube (QFT-GIT) assay, and chest radiography were performed. Results: A total of 153 participants were enrolled in the study. The mean age of the subjects was $21.9{\pm}0.9$ years, 105 (68.6%) were male, and 132 (86.3%) had been vaccinated with Bacille Calmette-Gu$\acute{e}$rin (BCG). Four students (2.6%) had a history of contact with tuberculosis (TB) patients during medical practice. No abnormal chest radiograph findings were found for any of the subjects. Of the 153 subjects, 23 (15.0%) tested positive for the TST, and 8 (5.2%) tested positive for the QFT-GIT. The agreement between the two tests was determined to be 0.34 using kappa coefficients. Of the four students who had a history of contact with TB patients, only one subject tested positive for both tests, and the other three students tested negative for both tests. Conclusion: A low prevalence of LTBI was found among medical students before clerkship course in South Korea.

제주시 중고등학생의 잠복결핵감염 진단을 위한 체외 인터페론감마검사의 유용성 (An Usefulness of In Vitro Interferon Gamma Assay for the Diagnosis of Latent Tuberculosis Infection in Middle- and High-School Students in Jeju-Shi, Korea)

  • 배종면;김은희;왕옥보
    • Tuberculosis and Respiratory Diseases
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    • 제68권3호
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    • pp.155-161
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    • 2010
  • Background: The tuberculin skin test (TST) has limitations in diagnosing a latent tuberculosis infection (LTBI). The interferon-gamma release assay (IGRA) was introduced to middle- and high-school students since 2009 by the Korea Centers for Disease Control and Prevention. The aim was to evaluate the utility of IGRA in diagnosing LTBI in middle- and high-school students. Methods: From August 2007 to July 2009, among suspected LTBI students showing TST induration with a 10 mm diameter and over with a normal chest x-ray in school students of Jeju city, 341 students underwent a Quanti FERON-TB Gold In-Tube (QFT-IT) test to confirm LTBI. Results: From 348 students showing a positive TST, a QFT-IT test was carried out on 341 students. The positive QFT-IT rate was 52.8% (=180/341). The positive QFT-IT rate was higher in high-school boys with a 15~19 mm diameter of induration in TST. Conclusion: With the introduction of IGRA for diagnosing LTBI in middle- and high-school students, approximately 47% of students who show a TST induration with a 10 mm diameter and over can avoid taking unnecessary preventive chemotherapy. These results suggest that IGRA is useful for diagnosing and controlling LTBI in Korean students.