The effect of M. tuberculosis lineage on clinical phenotype

• DOI: 10.1371/journal.pgph.0001788
• Publication Date: 2023-12-20T18:22:25Z
• Authors: Duc Hong Du; Ronald B. Geskus; Yanlin Zhao; Luigi Ruffo Codecasa; Daniela Maria Cir...; Reinout van Crevel; Dyshelly Nurkarti...; Lidya Chaidir; Stefan Niemann; Roland Diel; Shaheed Vally Omar; Louis Grandjean; Sakib Rokadiya; Arturo Torres Ortitz; Nguyễn Hữu Lân; Đặng Thị Minh Hà; E. Grace Smith; Esther Robinson; Martin Dedicoat; Le Thanh Hoang Nhat; Guy E. Thwaites; Le Hong Van; Nguyen Thuy Thuon...; Timothy M. Walker
• Keywords: Lineage (genetic)

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 from 12,246 patients 3 low-incidence 5 high-incidence countries. used multivariable logistic regression to explore the effect on site disease cavities chest radiography, given pulmonary TB; multinomial investigate types extra-pulmonary TB, lineage; accelerated failure time Cox proportional-hazards models smear culture-conversion. Mediation analyses quantified direct effects outcomes. Pulmonary was more likely among with lineage(L) 2, L3 L4, than L1 (adjusted odds ratio (aOR) 1.79, (95% confidence interval 1.49–2.15), p<0.001; aOR = 1.40(1.09–1.79), p 0.007; 2.04(1.65–2.53), p<0.001, respectively). Among those had greater risk radiography versus L2 (aOR 0.69(0.57–0.83), p<0.001) L4 strains 0.73(0.59–0.90), 0.002). were cause osteomyelitis L2-4 (p 0.033, 0.008 0.049 Patients showed shorter time-to-sputum conversion for L2. Causal mediation analysis each case largely direct. The pattern phenotypes seen differed modern (L2-4). This has implications management could influence trial selection strategies.