IJTLD openPub Date : 2026-04-13eCollection Date: 2026-04-01DOI: 10.5588/ijtldopen.25.0684
A F Dagnew, L L Han, A Cinar, D Gaikwad, A L Garcia-Basteiro, M T Gler, S R Hadinegoro, W A Hanekom, J R Lama, M Muyoyeta, S Musala, V Nduba, V C Rolla, T Roy, J S Sutherland, S Viegas, A Wajja, T M Walker, R Noble, L Schlehuber, J Sunshine, A C Schmidt
{"title":"Interferon-gamma release assay positivity in populations at high risk of TB infection.","authors":"A F Dagnew, L L Han, A Cinar, D Gaikwad, A L Garcia-Basteiro, M T Gler, S R Hadinegoro, W A Hanekom, J R Lama, M Muyoyeta, S Musala, V Nduba, V C Rolla, T Roy, J S Sutherland, S Viegas, A Wajja, T M Walker, R Noble, L Schlehuber, J Sunshine, A C Schmidt","doi":"10.5588/ijtldopen.25.0684","DOIUrl":"https://doi.org/10.5588/ijtldopen.25.0684","url":null,"abstract":"<p><strong>Background: </strong>Phase 3 TB vaccine trials are challenging in low-incidence settings due to the need for large sample sizes and extended follow-up. This global, observational study evaluated population-based interferon-gamma release assay (IGRA) status - a measure of TB infection (TBI), as a proxy for TB incidence to identify trial sites in high-incidence areas.</p><p><strong>Methods: </strong>Participants (15-34 years) were recruited from 45 sites in 14 countries. IGRA status at Day 1 and Month 12, association of IGRA status with age, and IGRA conversion (TBI) were assessed.</p><p><strong>Results: </strong>Among 7,164 enrolled participants, Day 1 IGRA positivity varied across sites and within countries, with the highest prevalence observed in South Africa (58.7%, site 1006; 53.1%, site 1010; 51.9%, site 1007) and the Democratic Republic of Congo (50.0%, site 2303). IGRA positivity was generally higher among older participants. At Month 12, sites with highest IGRA conversion were observed in the Philippines (32.3%, site 1507) and Zambia (30.6%, site 1303).</p><p><strong>Conclusion: </strong>In TB vaccine efficacy trials with clinical endpoints, selecting sites with the highest TB incidence is critical to optimise sample size and follow-up duration. Site-level IGRA status could inform site selection by identifying communities at increased risk of <i>Mycobacterium tuberculosis</i> infection.</p>","PeriodicalId":519984,"journal":{"name":"IJTLD open","volume":"3 4","pages":"232-240"},"PeriodicalIF":0.0,"publicationDate":"2026-04-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13080303/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147701762","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
IJTLD openPub Date : 2026-04-13eCollection Date: 2026-04-01DOI: 10.5588/ijtldopen.25.0424
A J F Bayot, M T Gler, E E Tolley, L Lorenzetti, E Namey, N Dinh, A Martinez, C Audibert, S Foraida, J Osborn, D Holtzman, C Vinnard, E A Talbot, C Wells
{"title":"A mixed-method study to inform the development of long-acting injectable TB treatments.","authors":"A J F Bayot, M T Gler, E E Tolley, L Lorenzetti, E Namey, N Dinh, A Martinez, C Audibert, S Foraida, J Osborn, D Holtzman, C Vinnard, E A Talbot, C Wells","doi":"10.5588/ijtldopen.25.0424","DOIUrl":"https://doi.org/10.5588/ijtldopen.25.0424","url":null,"abstract":"<p><strong>Background: </strong>Development of long-acting injectable (LAI) formulations of TB drugs could transform global TB management. We assessed three hypothetical LAI treatment scenarios and seven product-specific characteristics among TB patients and survivors, TB clinicians, and other key stakeholders.</p><p><strong>Methods: </strong>A two-stage, mixed-method study was conducted in the Philippines. Stage 1 included semi-structured interviews with 15 key informants (KIs) from public health organisations, government, and clinical practices. Stage 2 entailed face-to-face surveys and a discrete choice experiment (DCE) with TB health providers (n = 51), adult TB patients on treatment (n = 247), and TB survivors (n = 54) in one urban and one semi-urban setting.</p><p><strong>Results: </strong>Common themes identified through KI interviews included goals of minimising treatment burden, maximising adherence and efficacy, primary care setting preference, and the ability to monitor response. Relative to the oral standard of care, most participants reported that the LAI TB treatment scenarios were acceptable. Body placement of the injection was a driving characteristic of treatment choice for patients; preference for LAI treatment delivered through a primary care setting was reported as positively influencing treatment choice across respondent types.</p><p><strong>Conclusion: </strong>Multi-setting stakeholder input should guide development of LAI TB treatment so that developers can aim for acceptable product characteristics.</p>","PeriodicalId":519984,"journal":{"name":"IJTLD open","volume":"3 4","pages":"218-225"},"PeriodicalIF":0.0,"publicationDate":"2026-04-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13080306/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147701799","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
IJTLD openPub Date : 2026-04-13eCollection Date: 2026-04-01DOI: 10.5588/ijtldopen.25.0680
I Salles, E Lessem, L Walshe, B Myrzaliev, N B Hoa, M Shah, R E Chaisson, Y C Manabe
{"title":"Stakeholder engagement to identify barriers to implementation and inform the development of point-of-care diagnostics for TB.","authors":"I Salles, E Lessem, L Walshe, B Myrzaliev, N B Hoa, M Shah, R E Chaisson, Y C Manabe","doi":"10.5588/ijtldopen.25.0680","DOIUrl":"https://doi.org/10.5588/ijtldopen.25.0680","url":null,"abstract":"<p><strong>Background: </strong>Rapid TB diagnosis is crucial for improving outcomes and reducing transmission, yet nearly one third of cases remain undiagnosed or unreported. Point-of-care (POC) diagnostics are critical for bridging this gap.</p><p><strong>Methods: </strong>We surveyed stakeholder priorities for TB POC diagnostics to inform development aligned with global needs. An online survey was disseminated through SMART4TB partner networks over 13 weeks. The survey captured preferences for diagnostic features, testing obstacles, and attributes to strengthen TB response. Ranked preferences were analysed using weighted scoring with subgroup comparisons.</p><p><strong>Results: </strong>Of 274 respondents, 89% were from high-burden countries and represented diverse stakeholders; 57% (155/274) were TB care providers. Accuracy and rapid turnaround time to results were top diagnostic features. Primary obstacles were external sample transport and consumables availability. Key attributes to effective TB response included sensitive POC tests, close follow-up, and more personnel training to recognise TB. Paediatric TB screening training was infrequent, with 53% rarely or never trained.</p><p><strong>Conclusion: </strong>Accuracy and rapid turnaround are priority attributes for new TB POC diagnostics. Overcoming systemic barriers, including robust systems for identifying those who need screening, sample transport, material availability, and care continuity, is critical to achieving the successful implementation, and full impact of POC diagnostics.</p>","PeriodicalId":519984,"journal":{"name":"IJTLD open","volume":"3 4","pages":"255-261"},"PeriodicalIF":0.0,"publicationDate":"2026-04-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13080304/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147701761","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
IJTLD openPub Date : 2026-04-13eCollection Date: 2026-04-01DOI: 10.5588/ijtldopen.25.0728
M Amiri, M Cheraghi, M J Nasiri, D R Silva, G Sotgiu, L D'Ambrosio, R Centis, I Kontsevaya, H K Gandhi, D Oberdhan, V Girbinger, M Dara
{"title":"Safety of treatment regimens for drug-resistant TB over a 15-year period: a scoping review.","authors":"M Amiri, M Cheraghi, M J Nasiri, D R Silva, G Sotgiu, L D'Ambrosio, R Centis, I Kontsevaya, H K Gandhi, D Oberdhan, V Girbinger, M Dara","doi":"10.5588/ijtldopen.25.0728","DOIUrl":"https://doi.org/10.5588/ijtldopen.25.0728","url":null,"abstract":"<p><strong>Background: </strong>A previous review summarised the evolution and efficacy of the regimens to treat rifampicin-resistant/multidrug-resistant TB (RR/MDR-TB), underscoring the persistent need for efficacious shorter treatments. The aim of this scoping review was to explore safety, quality of life (QoL), and unmet needs associated with RR/MDR-TB in studies published between 2009 and 2024.</p><p><strong>Methods: </strong>We searched PubMed/MEDLINE, Embase, Cochrane CENTRAL, Scopus, and Web of Science for studies reporting safety, QoL, and unmet needs in the last 15 years.</p><p><strong>Results: </strong>Fifty-seven studies including 9,874 patients were identified, with significant variation in geographic distribution, sample size, and other core variables. The overall proportion of serious adverse events (AEs) ranged between 0.2% and 10.1% in retrospective studies, 1.0%-72.4% in prospective cohorts, and 20.0%-25.0% in experimental studies, with no data on QoL. Almost all studies containing linezolid (LZD) reported gastrointestinal and haematological AEs. In studies based on individual patient data, AEs associated with bedaquiline (1.7%-2.4%) and fluoroquinolones (3%-4%) were less frequent than those associated with LZD (14.1%-17.2%). The World Health Organization 95% credible interval range was 10.1%-27.0%.</p><p><strong>Conclusion: </strong>While efficacious RR/MDR-TB regimens are recommended, individual drugs still cause AEs potentially leading to decreased adherence. New efficacious treatments with improved safety/tolerability profiles are needed.</p>","PeriodicalId":519984,"journal":{"name":"IJTLD open","volume":"3 4","pages":"208-217"},"PeriodicalIF":0.0,"publicationDate":"2026-04-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13080302/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147701800","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
IJTLD openPub Date : 2026-04-13eCollection Date: 2026-04-01DOI: 10.5588/ijtldopen.25.0381
K Wendorf, C Dollinger, P Barry, A Readhead
{"title":"Pregnancy among people with TB disease.","authors":"K Wendorf, C Dollinger, P Barry, A Readhead","doi":"10.5588/ijtldopen.25.0381","DOIUrl":"https://doi.org/10.5588/ijtldopen.25.0381","url":null,"abstract":"<p><strong>Background: </strong>Globally, TB disproportionately impacts people of childbearing age. However, the impact of pregnancy among people with TB in California is unknown.</p><p><strong>Methods: </strong>Women aged 15-49 years with TB in California during 1993-2019 were matched to California birth records to identify those whose pregnancies or postpartum periods overlapped with TB treatment. Demographic and clinical variables were compared by pregnancy status, which included 'peri-pregnant' (all pregnant categories), 'pre-pregnant' (treatment started before and continued during pregnancy), 'pregnant' (treatment started during pregnancy), and 'postpartum' (treatment started within 3 months of a live birth).</p><p><strong>Results: </strong>Pregnancy and TB co-occurred among 7% of 15,092 individuals. Peri-pregnant people were more likely to be under 30 years old (<i>P</i> < 0.001), have recently immigrated (<i>P</i> < 0.001), and have pulmonary TB (<i>P</i> < 0.001) than nonpregnant people. Pregnant and postpartum people were 2.3 times more likely to have a TB diagnosis lacking microbiological confirmation than pre-pregnant people (95% confidence interval [1.7-3.2]). Pyrazinamide was used for >90% of pre-pregnant and postpartum groups, but 41% (<i>P</i> < 0.001) for people started on TB treatment while pregnant.</p><p><strong>Conclusion: </strong>Pregnancy occurs commonly among people of childbearing age with TB in California. Current TB screening practices among pregnant patients might prevent or detect early TB disease.</p>","PeriodicalId":519984,"journal":{"name":"IJTLD open","volume":"3 4","pages":"262-268"},"PeriodicalIF":0.0,"publicationDate":"2026-04-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13080307/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147701782","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
IJTLD openPub Date : 2026-04-13eCollection Date: 2026-04-01DOI: 10.5588/ijtldopen.25.0670
V Shukatka, L Skoklyuk, M Germanovych, A Bogdanov, T Ivanenko, N Zherebko, E Klinkenberg, G Dravniece
{"title":"Experiences from Ukraine in expanding TB infection diagnosis and treatment, including for drug-resistant TB.","authors":"V Shukatka, L Skoklyuk, M Germanovych, A Bogdanov, T Ivanenko, N Zherebko, E Klinkenberg, G Dravniece","doi":"10.5588/ijtldopen.25.0670","DOIUrl":"https://doi.org/10.5588/ijtldopen.25.0670","url":null,"abstract":"<p><strong>Background: </strong>Ukraine faces intersecting epidemics of HIV and drug-resistant TB (DR-TB), with high risk of progression from TB infection to active disease. The Support TB Control Efforts in Ukraine project supported the National TB Program's efforts to operationalise World Health Organization recommendations on TB infection testing and TB preventive treatment (TPT) across 17 regions of Ukraine.</p><p><strong>Design: </strong>In September 2021, QuantiFERON-TB Gold Plus (QFT-Plus) testing was introduced through a public-private laboratory model. Eligible populations included TB contacts and other high-risk groups. Data on referrals, test outcomes, and TPT initiation were collected electronically and analysed descriptively.</p><p><strong>Results: </strong>Out of 11,495 individuals referred for testing, 9,788 (85.2%) completed QFT-Plus testing, with adult TB contacts showing the highest positivity rate at 28.1%. Among 1,717 eligible for TPT, 1,512 (88.1%) started TPT, and this was 93.3% for drug-susceptible TB (DS-TB) contacts and 82.8% for DR-TB contacts. DS-TB contacts were offered shorter rifapentine-based regimens, while DR-TB contacts received levofloxacin. Implementation challenges were addressed through training and mentorship.</p><p><strong>Conclusion: </strong>Ukraine's implementation of QFT-Plus testing and shorter TPT regimens marks progress in broadening TB prevention efforts, particularly for DR-TB contacts. These initial results highlight that such approaches are feasible even in challenging, high-burden environments, offering insights for future expansion.</p>","PeriodicalId":519984,"journal":{"name":"IJTLD open","volume":"3 4","pages":"247-254"},"PeriodicalIF":0.0,"publicationDate":"2026-04-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13080308/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147701763","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
IJTLD openPub Date : 2026-04-13eCollection Date: 2026-04-01DOI: 10.5588/ijtldopen.25.0579
J Yang, M Choi, K S Yi, Y J Lee, E C Kim, G Min, M Kim, E Park, J Y Cho, Y M Shin, K H Choe, K M Lee, B Yang, S-H Kim
{"title":"Diagnostic determinants of acid-fast bacilli culture positivity in miliary TB.","authors":"J Yang, M Choi, K S Yi, Y J Lee, E C Kim, G Min, M Kim, E Park, J Y Cho, Y M Shin, K H Choe, K M Lee, B Yang, S-H Kim","doi":"10.5588/ijtldopen.25.0579","DOIUrl":"https://doi.org/10.5588/ijtldopen.25.0579","url":null,"abstract":"","PeriodicalId":519984,"journal":{"name":"IJTLD open","volume":"3 4","pages":"269-271"},"PeriodicalIF":0.0,"publicationDate":"2026-04-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13080311/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147701756","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
IJTLD openPub Date : 2026-04-13eCollection Date: 2026-04-01DOI: 10.5588/ijtldopen.25.0771
M A Yassin, A Rashid, E Wandwalo
{"title":"Can we optimise the TB response amid funding constraints using evidence-based, cost-effective strategies.","authors":"M A Yassin, A Rashid, E Wandwalo","doi":"10.5588/ijtldopen.25.0771","DOIUrl":"https://doi.org/10.5588/ijtldopen.25.0771","url":null,"abstract":"<p><strong>Background: </strong>Despite progress in the TB response, including through the Global Fund's catalytic efforts, funding gaps and inefficiencies threaten efforts to sustain gains and accelerate the TB response. Recent donor funding cuts have further strained programmes in low- and middle-income countries.</p><p><strong>Methods: </strong>A mixed-method, combining desk and literature review and key informant interviews with national TB programme stakeholders, technical experts, and partners, was conducted using standardised tools. Findings were triangulated to identify strategies/approaches that improve efficiency, access, and outcomes.</p><p><strong>Results: </strong>We identified cost-effective strategies that optimise resources and tools to sustain and expand access to services amid declining funding. Strategies to enhance efficiency include screening using digital X-rays (with artificial intelligence), testing samples (including pooled samples) with molecular diagnostics, decentralising care, engaging communities and private sector, and integrating TB services with broader health system. Cost-saving measures involve integrated sample transport and supervision, integrating TB with other diseases such as HIV, diabetes, and undernutrition, task shifting, shorter treatment regimens, digital tools, and e-learning. Emphasis was also placed on innovative financing, domestic resource mobilisation, and country ownership.</p><p><strong>Conclusion: </strong>Accelerating to end TB requires integrated and efficient strategies, innovative financing, and increased domestic resources, ensuring provision of equitable and high-quality TB services while strengthening the health system and ensuring sustainability.</p>","PeriodicalId":519984,"journal":{"name":"IJTLD open","volume":"3 4","pages":"200-207"},"PeriodicalIF":0.0,"publicationDate":"2026-04-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13080301/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147701798","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
IJTLD openPub Date : 2026-04-13eCollection Date: 2026-04-01DOI: 10.5588/ijtldopen.26.0044
F Ahmad Khan, R Menzies, A Ashesh, E Bijker, S Brode, E J Carter, E C Casas, J Campbell, C Denkinger, S Deborggraeve, I Evlampidou, J Furin, M Farhat, M M O Farouk, F Gafar, G Günther, L Guglielmetti, P Isaakidis, F Jouberton, N Khambati, P Y Khan, U Khan, R Long, S Law, A Matteelli, D Malden, I Motta, M Murray, T Masini, M Rich, R Ruslami, C Sepulcri, T Sunyoto, S Tunesi, E B Wong, A Zaffagnini
{"title":"Response to the Union's statement on ongoing conflicts and impact on health services.","authors":"F Ahmad Khan, R Menzies, A Ashesh, E Bijker, S Brode, E J Carter, E C Casas, J Campbell, C Denkinger, S Deborggraeve, I Evlampidou, J Furin, M Farhat, M M O Farouk, F Gafar, G Günther, L Guglielmetti, P Isaakidis, F Jouberton, N Khambati, P Y Khan, U Khan, R Long, S Law, A Matteelli, D Malden, I Motta, M Murray, T Masini, M Rich, R Ruslami, C Sepulcri, T Sunyoto, S Tunesi, E B Wong, A Zaffagnini","doi":"10.5588/ijtldopen.26.0044","DOIUrl":"https://doi.org/10.5588/ijtldopen.26.0044","url":null,"abstract":"","PeriodicalId":519984,"journal":{"name":"IJTLD open","volume":"3 4","pages":"272-274"},"PeriodicalIF":0.0,"publicationDate":"2026-04-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13080309/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147701785","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
IJTLD openPub Date : 2026-04-13eCollection Date: 2026-04-01DOI: 10.5588/ijtldopen.25.0677
I Flores, M A A Tujan, R Basilio, T J R Dizon, D R Lim, L T Reyes, R V A G Reyes, S Rojas, A K Valencia, J B Capin, V Mirtskhulava, A G Palparan, C Cabalitan, P J Carpin, C Malbacias, J S Lee, A Gebhard, M Quelapio, J Timm
{"title":"High efficacy of BPaL among patients infected with <i>Mycobacterium tuberculosis</i> lineage 1 in the Philippines.","authors":"I Flores, M A A Tujan, R Basilio, T J R Dizon, D R Lim, L T Reyes, R V A G Reyes, S Rojas, A K Valencia, J B Capin, V Mirtskhulava, A G Palparan, C Cabalitan, P J Carpin, C Malbacias, J S Lee, A Gebhard, M Quelapio, J Timm","doi":"10.5588/ijtldopen.25.0677","DOIUrl":"https://doi.org/10.5588/ijtldopen.25.0677","url":null,"abstract":"<p><strong>Background: </strong>WHO recommends the bedaquiline-pretomanid-linezolid regimen with/without moxifloxacin (M) (BPaL/M) for the treatment of multidrug- or rifampicin-resistant TB. However, <i>Mycobacterium tuberculosis</i> (MTB) lineage 1 (L1) is less susceptible to pretomanid than other lineages, and there are limited BPaL/M efficacy data from regions where L1 is prevalent.</p><p><strong>Methods: </strong>We performed whole genome sequencing (WGS) on baseline MTB isolates from a subgroup (34/103) of patients from the highly successful Philippine BPaL Operational Research Study to characterise their lineage and genotypic drug susceptibility testing (DST) profile. Phenotypic DST for BPaL drugs was also conducted.</p><p><strong>Results: </strong>WGS analysis showed that L1 (68%) predominated, followed by L4 (26%) and L2 (6%). Out of the 22 L1 isolates tested, 20 exhibited higher pretomanid minimum inhibitory concentrations than isolates from other lineages, including one with borderline resistance. Two patients had confirmed bedaquiline resistance; no linezolid resistance was detected. All 34 patients with characterised isolates had culture converted by end of treatment. At month 12 follow-up, 30/31 patients who provided sputum remained culture negative; the single culture-positive participant harboured MTB L4.</p><p><strong>Conclusion: </strong>In this study, patients infected with MTB L1 responded to BPaL as well as those infected with other lineages. Baseline bedaquiline resistance was linked to the unique recurrence in the study.</p>","PeriodicalId":519984,"journal":{"name":"IJTLD open","volume":"3 4","pages":"226-231"},"PeriodicalIF":0.0,"publicationDate":"2026-04-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13080305/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147701778","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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