Shijia Ge, Kui Liu, Xineng Jiang, Zhen Feng, Songhua Chen, Yaling Feng, Guoyong Jiang, Zhicheng Yu, Lingyun Song, Lingyun Shao, Yilin Zhang, Feng Sun, Tao Li, Bin Chen, Yang Li, Wenhong Zhang
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引用次数: 0
Abstract
Background: Individuals with asymptomatic tuberculosis (TB) are considered a significant risk to the disease burden and transmission. However, the progression and treatment for asymptomatic TB remain incompletely described.
Methods: This prospective cohort study was embedded within a prevalence survey conducted in 2021 and 2022 in Lanxi County, China. All patients with pulmonary TB who consented to participate would be included in the study and were categorized as asymptomatic or symptomatic. For the primary analysis, asymptomatic TB was defined as the absence of current cough, fever, night sweats, weight loss, or hemoptysis. Patients were followed up until 10 November 2024.
Results: Among 109 345 individuals screened, 193 were included, of whom 101 (52.3%) were symptomatic and 92 (47.7%) were asymptomatic. The proportion of asymptomatic TB varied from 32.5% to 62.7% depending on varying symptom negative threshold. Fewer asymptomatic patients were bacteriologically confirmed compared to symptomatic patients (71.7% [66/92] vs 90.1% [91/101], P = .001). The median time for asymptomatic patients at screening to develop symptoms was 102 days. Most patients in both groups received treatment for active TB (97.8% vs 99.0%, P = .606). The treatment success rate among asymptomatic patients was comparable to that of symptomatic patients (93.3% vs 96.0%, P = .521), but their treatment duration was significantly shorter (196 vs 273 days, P < .001).
Conclusions: In the community setting, a significant number of TB cases were asymptomatic and remained so for months. These cases demonstrated satisfactory treatment coverage and outcomes, with shorter durations compared to symptomatic TB, suggesting the potential for developing shorter regimens for asymptomatic TB.
背景：无症状结核病（TB）患者被认为对疾病负担和传播具有重大风险。然而，对无症状结核病的进展和治疗仍然描述不完全。方法：这项前瞻性队列研究嵌入了2021年和2022年在中国兰溪县进行的一项患病率调查。所有同意参与的肺结核患者将被纳入研究，并被分类为无症状或有症状。在初步分析中，无症状结核病被定义为没有当前的咳嗽、发热、盗汗、体重减轻或咯血。患者随访至2024年11月10日。结果：在109 345例筛查人群中，纳入193例，其中101例（52.3%）有症状，92例（47.7%）无症状。根据不同的症状阴性阈值，无症状结核病的比例从32.5%到62.7%不等。与有症状患者相比，无症状患者的细菌学确诊较少（71.7% [66/92]vs 90.1% [91/101], P = .001）。无症状患者在筛查时出现症状的中位时间为102天。两组中大多数患者接受了活动性结核病治疗（97.8% vs 99.0%, P = 0.606）。无症状组的治疗成功率与有症状组相当（93.3% vs 96.0%, P = 0.521），但治疗时间明显短于有症状组（196 vs 273天，P < 0.001）。结论：在社区环境中，相当数量的结核病例无症状且持续数月。这些病例显示出令人满意的治疗覆盖率和结果，与有症状结核病相比，持续时间较短，这表明有可能开发出治疗无症状结核病的较短方案。
期刊介绍：
Open Forum Infectious Diseases provides a global forum for the publication of clinical, translational, and basic research findings in a fully open access, online journal environment. The journal reflects the broad diversity of the field of infectious diseases, and focuses on the intersection of biomedical science and clinical practice, with a particular emphasis on knowledge that holds the potential to improve patient care in populations around the world. Fully peer-reviewed, OFID supports the international community of infectious diseases experts by providing a venue for articles that further the understanding of all aspects of infectious diseases.
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