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Free Content Demographic risk factors and lymphocyte populations in patients with tuberculosis and their healthy contacts

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SETTING: Campania, a southern region of Italy, and the Institute of Respiratory Diseases, Monaldi Hospital, University ‘Federico II’, Naples.

OBJECTIVE: To evaluate clinical and socio-demographic risk factors for tuberculosis (TB) infection and/or disease. Peripheral blood lymphocytes from a sub-cohort of 19 patients and 53 contacts were studied by flow cytometry.

DESIGN: A prospective study among patients with newly diagnosed pulmonary tuberculosis and their close contacts.

RESULTS: A total of 90 patients and 277 contacts were enrolled. The prevalence of infection was 45% (95%CI 39–51%) among contacts. Age, sex, delay in diagnosis and treatment, cavitation on chest radiograph, cough, unwillingness to cover the mouth, and volume of air shared by close contacts and patients were investigated as potential risk factors for infection. Only delay in diagnosis of cases remained independently associated with an increased risk of infection (P < 0.0002), and hemoptysis was the only factor capable of reducing the delay significantly. The CD8+CD28+ cytotoxic subset was significantly diminished in the patients (P < 0.001), whereas the CD8+CD28- and CD8+CD57+ (suppressor and NK-like subsets) were elevated (P < 0.001 and P = 0.04).

CONCLUSIONS: These data show that delay in diagnosis of cases is a crucial factor for tuberculosis and that cytotoxic CD81 cells play a primary role in immune response to tuberculosis.

Keywords: chemoprophylaxis; contact tracing; immune response; lymphocyte subsets; tuberculosis transmission

Document Type: Regular Paper

Affiliations: 1: Institute of Respiratory Diseases, University ‘Federico II’ of Naples, UNESCO Unit for Research, Diagnosis and Prevention of Tuberculosis, Monaldi Hospital, Naples, Italy 2: Institute of Epidemiology & Biostatistics, Department of Medical Informatics, Erasmus University Rotterdam, The Netherlands

Publication date: December 1, 2001

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  • The International Journal of Tuberculosis and Lung Disease publishes articles on all aspects of lung health, including public health-related issues such as training programmes, cost-benefit analysis, legislation, epidemiology, intervention studies and health systems research. The IJTLD is dedicated to the continuing education of physicians and health personnel and the dissemination of information on tuberculosis and lung health world-wide.

    Certain IJTLD articles are selected for translation into French, Spanish, Chinese or Russian. They are available on the Union website

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