Author:
Shanmugam Sivakumar,Bachmann Nathan L,Martinez Elena,Menon Ranjeeta,Narendran Gopalan,Narayanan Sujantha,Tripathy Srikanth,Devi K R Uma,Sawleshwarkar Shailendra,Marais Ben,Sintchenko Vitali
Abstract
AbstractDifferentiation between relapse and reinfection in cases with tuberculosis (TB) recurrence has important implications for public health, especially in patients with human immunodeficiency virus (HIV) co-infection. Forty-one paired M. tuberculosis isolates collected from 20 HIV-positive and 21 HIV-negative patients, who experienced TB recurrence after previous successful treatment, were subjected to whole genome sequencing (WGS) in addition to spoligotyping and mycobacterial interspersed repeat unit (MIRU) typing. Comparison of M. tuberculosis genomes indicated that 95% of TB recurrences in the HIV-negative cohort were due to relapse, while the majority of TB recurrences (75%) in the HIV-positive cohort was due to re-infection (P=0.0001). Drug resistance conferring mutations were documented in four pairs (9%) of isolates associated with relapse. The high contribution of re-infection to TB among HIV patients warrants further study to explore risk factors for TB exposure in the community.
Publisher
Cold Spring Harbor Laboratory