Understanding the interaction between cytomegalovirus and tuberculosis in children: The way forward
Author(s)
Type
Journal Article
Abstract
Over 1 million children develop tuberculosis (TB) each year, with a quarter dying. Multiple factors impact the risk of a child being exposed to Mycobacterium tuberculosis (Mtb), the risk of progressing to TB disease, and the risk of dying. However, an emerging body of evidence suggests that coinfection with cytomegalovirus (CMV), a ubiquitous herpes virus, impacts the host response to Mtb, potentially influencing the probability of disease progression, type of TB disease, performance of TB diagnostics, and disease outcome. It is also likely that infection with Mtb impacts CMV pathogenesis. Our current understanding of the burden of these 2 diseases in children, their immunological interactions, and the clinical consequence of coinfection is incomplete. It is also unclear how potential interventions might affect disease progression and outcome for TB or CMV. This article reviews the epidemiological, clinical, and immunological literature on CMV and TB in children and explores how the 2 pathogens interact, while also considering the impact of HIV on this relationship. It outlines areas of research uncertainty and makes practical suggestions as to potential studies that might address these gaps. Current research is hampered by inconsistent definitions, study designs, and laboratory practices, and more consistency and collaboration between researchers would lead to greater clarity. The ambitious targets outlined in the World Health Organization End TB Strategy will only be met through a better understanding of all aspects of child TB, including the substantial impact of coinfections.
Date Issued
2021-12-01
Date Acceptance
2021-12-01
Citation
PLoS Pathogens, 2021, 17 (12), pp.1-21
ISSN
1553-7366
Publisher
Public Library of Science (PLoS)
Start Page
1
End Page
21
Journal / Book Title
PLoS Pathogens
Volume
17
Issue
12
Copyright Statement
© 2021 Olbrich et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
License URL
Sponsor
The European Society for Paediatric Infectious Diseases
Identifier
http://gateway.webofknowledge.com/gateway/Gateway.cgi?GWVersion=2&SrcApp=PARTNER_APP&SrcAuth=LinksAMR&KeyUT=WOS:000729502700004&DestLinkType=FullRecord&DestApp=ALL_WOS&UsrCustomerID=1ba7043ffcc86c417c072aa74d649202
Grant Number
18/LO/0379
Subjects
Science & Technology
Life Sciences & Biomedicine
Microbiology
Parasitology
Virology
MYCOBACTERIUM-TUBERCULOSIS
IMMUNE ACTIVATION
CELL RESPONSES
GLOBAL BURDEN
T-CELLS
INFECTION
CMV
DISEASE
VACCINE
RISK
Publication Status
Published
Article Number
ARTN e1010061
Date Publish Online
2021-12-09