Browsing by Author "Cangelosi, Gerard A."

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    Isoniazid preventive therapy and tuberculosis transcriptional signatures in people with HIV
    (Wolters Kluwer, 2022) Valinetz, Ethan D.; Matemo, Daniel; Gersh, Jill K.; Joudeh, Lara L.; Mendelsohn, Simon C.; Scriba, Thomas J.; Hatherill, Mark; Kinuthia, John; Wald, Anna; Cangelosi, Gerard A.; Barnabas, Ruanne V.; Hawn, Thomas R.; Horne, David J.; Medicine, School of Medicine
    Objectives: To examine the association between isoniazid preventive therapy (IPT) or nontuberculous mycobacteria (NTM) sputum culture positivity and tuberculosis (TB) transcriptional signatures in people with HIV. Design: Cross-sectional study. Methods: We enrolled adults living with HIV who were IPT-naive or had completed IPT more than 6 months prior at HIV care clinics in western Kenya. We calculated TB signatures using gene expression data from qRT-PCR. We used multivariable linear regression to analyze the association between prior receipt of IPT or NTM sputum culture positivity with a transcriptional TB risk score, RISK6 (range 0-1). In secondary analyses, we explored the association between IPT or NTM positivity and four other TB transcriptional signatures. Results: Among 381 participants, 99.7% were receiving antiretroviral therapy and 86.6% had received IPT (completed median of 1.1 years prior). RISK6 scores were lower (mean difference 0.10; 95% confidence interval (CI): 0.06-0.15; P < 0.001) among participants who received IPT than those who did not. In a model that adjusted for age, sex, duration of ART, and plasma HIV RNA, the RISK6 score was 52.8% lower in those with a history of IPT ( P < 0.001). No significant association between year of IPT receipt and RISK6 scores was detected. There was no association between NTM sputum culture positivity and RISK6 scores. Conclusion: In people with HIV, IPT was associated with significantly lower RISK6 scores compared with persons who did not receive IPT. These data support investigations of its performance as a TB preventive therapy response biomarker.