IGRA sensitivity profile for screening and diagnosing latent Mycobacterium tuberculosis infection in children and adolescents with Neoplasms

• Grant number: 23/04347-7
• Support Opportunities: Regular Research Grants
• Start date: September 01, 2023
• End date: August 31, 2025
• Field of knowledge: Health Sciences - Medicine - Maternal and Child Health
• Principal Investigator: Haroldo Teófilo de Carvalho
• Grantee: Haroldo Teófilo de Carvalho
• Host Institution: Faculdade de Medicina (FMB). Universidade Estadual Paulista (UNESP). Campus de Botucatu. Botucatu , SP, Brazil

Abstract

Discovered in 1882 by the German bacteriologist Robert Koch, tuberculosis is one of the oldest diseases in the world. Transmission is via the respiratory route, through the inhalation of aerosols produced by the cough, speech or sneeze of a patient with active pulmonary or laryngeal tuberculosis, and is caused in most cases by the bacterium Mycobacterium tuberculosis. In contrast, in latent tuberculosis infection (LTBI), a person is infected but does not show signs of active disease. In general, infected people remain healthy for many years, without transmitting the bacillus, and with partial immunity to the disease. The population most at risk of having severe or disseminated active disease are children under two years of age and those who are immunosuppressed. An individual infected with Mycobacterium tuberculosis, identified by means of PT or IGRA, is considered a case of LTBI, provided that active TB is properly ruled out. LTBI screening must exclude active disease, with special attention to populations at higher risk of illness. The IGRA (Interferon-Gamma Release Assays) have been shown to be an excellent tool for the diagnosis of LTBI, as children show robust IFN-³ responses to M. tuberculosis antigens. The literature has shown a significant increase in the diagnosis of latent tuberculosis in cancer patients, especially in those with neoplasms of the hematological system, being associated with an approximately two-fold increase in the risk of developing the disease; thus, accurate and early detection of LTBI is becoming increasingly important. With this, the objective of this research is to track and diagnose LTBI in patients with neoplastic diseases submitted to immunosuppression or immunosuppressed due to the disease itself, in order to establish adequate treatment and follow-up for these patients, with a consequent reduction in morbidity and mortality due to the disease. (AU)