TY - JOUR
T1 - The convergent epidemiology of tuberculosis and human cytomegalovirus infection [version 2; referees: 2 approved]
AU - Cobelens, Frank
AU - Nagelkerke, Nico
AU - Fletcher, Helen
PY - 2018
Y1 - 2018
N2 - Although several factors are known to increase the risk of tuberculosis, the occurrence of tuberculosis disease in an infected individual is difficult to predict. We hypothesize that active human cytomegalovirus infection due to recent infection, reinfection or reactivation plays an epidemiologically relevant role in the aetiology of tuberculosis by precipitating the progression from latent tuberculosis infection to disease. The most compelling support for this hypothesis comes from the striking similarity in age-sex distribution between the two infections, important because the age-sex pattern of tuberculosis disease progression has not been convincingly explained. Cytomegalovirus infection and tuberculosis have other overlapping risk factors, including poor socio-economic status, solid organ transplantation and, possibly, sexual contact and whole blood transfusion. Although each of these overlaps could be explained by shared underlying risk factors, none of the epidemiological observations refute the hypothesis. If this interaction would play an epidemiologically important role, important opportunities would arise for novel approaches to controlling tuberculosis.
AB - Although several factors are known to increase the risk of tuberculosis, the occurrence of tuberculosis disease in an infected individual is difficult to predict. We hypothesize that active human cytomegalovirus infection due to recent infection, reinfection or reactivation plays an epidemiologically relevant role in the aetiology of tuberculosis by precipitating the progression from latent tuberculosis infection to disease. The most compelling support for this hypothesis comes from the striking similarity in age-sex distribution between the two infections, important because the age-sex pattern of tuberculosis disease progression has not been convincingly explained. Cytomegalovirus infection and tuberculosis have other overlapping risk factors, including poor socio-economic status, solid organ transplantation and, possibly, sexual contact and whole blood transfusion. Although each of these overlaps could be explained by shared underlying risk factors, none of the epidemiological observations refute the hypothesis. If this interaction would play an epidemiologically important role, important opportunities would arise for novel approaches to controlling tuberculosis.
UR - https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=85046667708&origin=inward
UR - https://www.ncbi.nlm.nih.gov/pubmed/29780582
U2 - https://doi.org/10.12688/f1000research.14184.2
DO - https://doi.org/10.12688/f1000research.14184.2
M3 - Article
C2 - 29780582
SN - 2046-1402
VL - 7
JO - F1000Research
JF - F1000Research
M1 - 280
ER -