The effect of M. tuberculosis lineage on clinical phenotype

• Published in: PLOS global public health 2023-12, Vol.3 (12), p.e0001788
• Main Authors: Du, Duc Hong, Geskus, Ronald B, Zhao, Yanlin, Codecasa, Luigi Ruffo, Cirillo, Daniela Maria, van Crevel, Reinout, Pascapurnama, Dyshelly Nurkartika, Chaidir, Lidya, Niemann, Stefan, Diel, Roland, Omar, Shaheed Vally, Grandjean, Louis, Rokadiya, Sakib, Ortitz, Arturo Torres, Lân, Nguyễn Hữu, Hà, Đặng Thị Minh, Smith, E Grace, Robinson, Esther, Dedicoat, Martin, Nhat, Le Thanh Hoang, Thwaites, Guy E, Van, Le Hong, Thuong, Nguyen Thuy Thuong, Walker, Timothy M
• Format: Article
• Language: English
• Subjects: Medicine and Health Sciences; People and Places
• ISSN: 2767-3375; 2767-3375
• DOI: 10.1371/journal.pgph.0001788

Six lineages of Mycobacterium tuberculosis sensu stricto (which excludes M. africanum) are described. Single-country or small observational data suggest differences in clinical phenotype between lineages. We present strain lineage and clinical phenotype data from 12,246 patients from 3 low-incidence and 5 high-incidence countries. We used multivariable logistic regression to explore the effect of lineage on site of disease and on cavities on chest radiography, given pulmonary TB; multivariable multinomial logistic regression to investigate types of extra-pulmonary TB, given lineage; and accelerated failure time and Cox proportional-hazards models to explore the effect of lineage on time to smear and culture-conversion. Mediation analyses quantified the direct effects of lineage on outcomes. Pulmonary disease was more likely among patients with lineage(L) 2, L3 or L4, than L1 (adjusted odds ratio (aOR) 1.79, (95% confidence interval 1.49-2.15), p