Latent Tuberculosis Infection and Associated Risk Factors among People Living with HIV and HIV-Uninfected Individuals in Lithuania

The World Health Organization (WHO) estimated that 8% of the 9.9 million people worldwide who developed tuberculosis (TB) in 2020 were those living with human immunodeficiency virus (HIV). Additionally, the WHO highlighted that, for the first time in over a decade, the TB death rate has increased because of decreased access to prevention and care due to the COVID-19 pandemic. Mortality related to acquired immune deficiency syndrome (AIDS) remains high in Eastern Europe, and pulmonary TB is the most common AIDS-defining condition in this region. A considerable proportion of people living with HIV (PLHIV) in Eastern Europe have a delayed diagnosis of TB, leading to a higher risk of death, and TB remains undiagnosed at death for a number of PLHIV.

Latent tuberculosis infection (LTBI) is defined as a state of persistent immune response to stimulation by Mycobacterium tuberculosis antigens with no evidence of clinically manifested active TB. WHO estimated that 1.8 billion people, or one-third of the world’s population, had LTBI in 1999. In 2016, the global prevalence of LTBI was updated to 23%, which corresponds to 1.7 billion people infected worldwide. Studies have shown that <3% of these people will develop active TB over the course of their lifetime, the risk being 20–100 times higher among PLHIV.

pdf 996 KB 2023-08-07

Molecular characterization of invasive Neisseria meningitidis isolates collected in Lithuania (2009-2019) and estimation of serogroup B meningococcal vaccine 4CMenB and MenBFhbp coverage

Neisseria meningitidis causes invasive meningococcal disease (IMD), which is associated with significant mortality and long-term consequences, especially among young children. The incidence of IMD in Lithuania was among the highest in European Union/European Economic Area countries during the past two decades; however, the characterization of meningococcal isolates by molecular typing methods has not yet been performed. In this study, we characterized invasive meningococcal isolates (n=294) recovered in Lithuania from 2009 to 2019 by multilocus sequence typing (MLST) and typing of antigens FetA and PorA. The more recent (2017-2019) serogroup B isolates (n=60) were genotyped by analyzing vaccine-related antigens to evaluate their coverage by fourcomponent (4CMenB) and two-component (MenB-Fhbp) vaccines using the genetic Meningococcal Antigen Typing System (gMATS) and Meningococcal Deduced Vaccine Antigen Reactivity (MenDeVAR) Index methods, respectively. The vast majority (90.5%) of isolates belonged to serogroup B. MLST revealed a predominance of clonal complex 32 (74.02%). Serogroup B strain P1.19,15: F4- 28: ST-34 (cc32) accounted for 64.1% of IMD isolates. The overall level of strain coverage by the 4MenB vaccine was 94.8% (CI 85.9-98.2%). Most serogroup B isolates (87.9%) were covered by a single vaccine antigen, most commonly Fhbp peptide variant 1 (84.5% of isolates). The Fhbp peptides included in the MenBFhbp vaccine were not detected among the analyzed invasive isolates; however, the identified predominant variant 1 was considered cross-reactive. In total, 88.1% (CI 77.5-94.1) of isolates were predicted to be covered by the MenB-Fhbp vaccine. In conclusion, both serogroup B vaccines demonstrate potential to protect against IMD in Lithuania.

pdf 1 MB 2023-04-19

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