Journal Article Research Support, N.I.H., Extramural Research Support, Non-U.S. Gov't Epublish 7 citations
PubMed: 34711213 DOI: 10.1186/s12916-021-02127-w
The impact of blood transcriptomic biomarker targeted tuberculosis preventive therapy in people living with HIV: a mathematical modelling study.
BMC Med 19(1):252
Authors: Tom Sumner, Simon C Mendelsohn, Thomas J Scriba, Mark Hatherill, Richard G White
Affiliations
- TB Modelling Group, TB Centre, Centre for Mathematical Modelling of Infectious Diseases, Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK.
- South African Tuberculosis Vaccine Initiative, Institute of Infectious Disease and Molecular Medicine, Division of Immunology, Department of Pathology, University of Cape Town, Cape Town, South Africa.
- TB Modelling Group, TB Centre, Centre for Mathematical Modelling of Infectious Diseases, Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK.
Abstract
BACKGROUND
Tuberculosis (TB) preventive therapy is recommended for all people living with HIV (PLHIV). Despite the elevated risk of TB amongst PLHIV, most of those eligible for preventive therapy would never develop TB. Tests which can identify individuals at greatest risk of disease would allow more efficient targeting of preventive therapy.
METHODS
We used mathematical modelling to estimate the potential impact of using a blood transcriptomic biomarker (RISK11) to target preventive therapy amongst PLHIV. We compared universal treatment to RISK11 targeted treatment and explored the effect of repeat screening of the population with RISK11.
RESULTS
Annual RISK11 screening, with preventive therapy provided to those testing positive, could avert 26% (95% CI 13-34) more cases over 10 years compared to one round of universal treatment. For the cost per case averted to be lower than universal treatment, the maximum cost of the RISK11 test was approximately 10% of the cost of preventive therapy. The benefit of RISK11 screening may be greatest amongst PLHIV on ART (compared to ART naïve individuals) due to the increased specificity of the test in this group.
CONCLUSIONS
Biomarker targeted preventive therapy may be more effective than universal treatment amongst PLHIV in high incidence settings but would require repeat screening.
MeSH
Risk, Biomarkers, Tuberculosis, Therapeutics, Blood, Hiv
Cited by
- Prospective multicentre head-to-head validation of host blood transcriptomic biomarkers for pulmonary tuberculosis by real-time PCR. Commun Med (Lond), 2022
- Cost-effectiveness of screening with transcriptional signatures for incipient TB among U.S. migrants. medRxiv, 2024
- Transcriptomic Signatures of Progression to Tuberculosis Disease Among Close Contacts in Brazil. J Infect Dis, 2024
- Cost-effectiveness of screening with transcriptional signatures for incipient TB among U.S. migrants. PLoS Med, 2025