Swanepoel Jeremi, van Zyl Gert, Hesseling Anneke C, Johnson Sarah M, Moore David A J, Seddon James A
Desmond Tutu TB Centre, Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa.
Department of Clinical Research, London School of Hygiene and Tropical Medicine, London, United Kingdom.
Open Forum Infect Dis. 2023 Sep 29;10(11):ofad487. doi: 10.1093/ofid/ofad487. eCollection 2023 Nov.
Emerging evidence suggests a link between infection with herpes viruses, particularly human cytomegalovirus (HCMV) and Epstein-Barr virus (EBV), and progression to tuberculosis disease.
An unmatched case-control study was conducted among adolescents aged 10-19 years enrolled in an observational study (Teen TB) between November 2020 and November 2021, in Cape Town, South Africa. Fifty individuals with pulmonary tuberculosis and 51 healthy tuberculosis-exposed individuals without tuberculosis were included. Demographics and clinical data were obtained, and serum samples collected at enrolment were tested for HCMV immunoglobulin G (IgG) and EBV nuclear antigen (EBNA) IgG using 2 automated enzyme immunoassays. Odds ratios were estimated using unconditional logistic regression.
The median age of 101 participants was 15 years (interquartile range, 13-17 years); 55 (54%) were female. All participants were HCMV IgG seropositive, and 95% were EBNA IgG seropositive. Individuals with tuberculosis had higher HCMV IgG titers than healthy controls ( = .04). Individuals with upper-tertile HCMV IgG titers had 3.67 times greater odds of pulmonary tuberculosis than those with IgG titers in the lower tertile (95% confidence interval, 1.05-12.84; = .04). There was a trend for increasing odds of pulmonary tuberculosis with increasing titers of HCMV IgG ( = .04). In contrast, there was no association between tuberculosis and higher EBNA IgG values.
There is a high prevalence of sensitization to HCMV and EBV among adolescents in this high-tuberculosis-burden setting. Higher HCMV IgG titers were associated with pulmonary tuberculosis in adolescents.
新出现的证据表明，感染疱疹病毒，尤其是人类巨细胞病毒（HCMV）和爱泼斯坦-巴尔病毒（EBV）与结核病进展之间存在联系。
2020年11月至2021年11月期间，在南非开普敦对参与一项观察性研究（青少年结核病研究）的10至19岁青少年进行了一项非匹配病例对照研究。纳入了50例肺结核患者和51例未患结核病的健康结核暴露个体。获取了人口统计学和临床数据，并使用2种自动酶免疫测定法对入组时采集的血清样本进行了HCMV免疫球蛋白G（IgG）和EBV核抗原（EBNA）IgG检测。使用无条件逻辑回归估计比值比。
101名参与者的中位年龄为15岁（四分位间距，13 - 17岁）；55名（54%）为女性。所有参与者HCMV IgG血清学均为阳性，95%为EBNA IgG血清学阳性。肺结核患者的HCMV IgG滴度高于健康对照（P = 0.04）。HCMV IgG滴度处于上三分位数的个体患肺结核的几率是IgG滴度处于下三分位数个体的3.67倍（95%置信区间，1.05 - 12.84；P = 0.04）。随着HCMV IgG滴度升高，患肺结核的几率有增加趋势（P = 0.04）。相比之下，结核病与较高的EBNA IgG值之间无关联。
在这个结核病负担高的环境中，青少年对HCMV和EBV致敏的患病率很高。青少年中较高的HCMV IgG滴度与肺结核有关。
