학술논문
Prolonged survival of a patient with active MDR-TB HIV co-morbidity: insights from a Mycobacterium tuberculosis strain with a unique genomic deletion.
Document Type
Academic Journal
Author
Rubinstein M; National Public Health Laboratory, Public Health Directorate, Ministry of Health, Tel Aviv, Israel.; Makhon A; National Public Health Laboratory, Public Health Directorate, Ministry of Health, Tel Aviv, Israel.; Losev Y; National Public Health Laboratory, Public Health Directorate, Ministry of Health, Tel Aviv, Israel.; Valenci GZ; National Public Health Laboratory, Public Health Directorate, Ministry of Health, Tel Aviv, Israel.; Gatt YE; Department of Microbiology and Molecular Genetics, Institute for Medical Research Israel-Canada, Faculty of Medicine, The Hebrew University of Jerusalem, Jerusalem, Israel.; Margalit H; Department of Microbiology and Molecular Genetics, Institute for Medical Research Israel-Canada, Faculty of Medicine, The Hebrew University of Jerusalem, Jerusalem, Israel.; Fass E; National Public Health Laboratory, Public Health Directorate, Ministry of Health, Tel Aviv, Israel.; Kutikov I; National Public Health Laboratory, Public Health Directorate, Ministry of Health, Tel Aviv, Israel.; Murik O; Translational Genomics Laboratory, Medical Genetics Institute, Shaare Zedek Medical Center, Jerusalem, Israel.; Zeevi DA; Translational Genomics Laboratory, Medical Genetics Institute, Shaare Zedek Medical Center, Jerusalem, Israel.; Savyon M; Tel Aviv District Health Office, Ministry of Health, Tel Aviv, Israel.; Tau L; Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.; Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.; Kaidar Shwartz H; National Public Health Laboratory, Public Health Directorate, Ministry of Health, Tel Aviv, Israel.; Dveyrin Z; National Public Health Laboratory, Public Health Directorate, Ministry of Health, Tel Aviv, Israel.; Rorman E; National Public Health Laboratory, Public Health Directorate, Ministry of Health, Tel Aviv, Israel.; Nissan I; National Public Health Laboratory, Public Health Directorate, Ministry of Health, Tel Aviv, Israel.
Source
Publisher: Frontiers Media S.A Country of Publication: Switzerland NLM ID: 101648047 Publication Model: eCollection Cited Medium: Print ISSN: 2296-858X (Print) Linking ISSN: 2296858X NLM ISO Abbreviation: Front Med (Lausanne) Subsets: PubMed not MEDLINE
Subject
Language
English
ISSN
2296-858X
Abstract
Coinfection of HIV and multidrug-resistant tuberculosis (MDR-TB) presents significant challenges in terms of the treatment and prognosis of tuberculosis, leading to complexities in managing the disease and impacting the overall outcome for TB patients. This study presents a remarkable case of a patient with MDR-TB and HIV coinfection who survived for over 8 years, despite poor treatment adherence and comorbidities. Whole genome sequencing (WGS) of the infecting Mycobacterium tuberculosis ( Mtb ) strain revealed a unique genomic deletion, spanning 18 genes, including key genes involved in hypoxia response, intracellular survival, immunodominant antigens, and dormancy. This deletion, that we have called "Del-X," potentially exerts a profound influence on the bacterial physiology and its virulence. Only few similar deletions were detected in other non-related Mtb genomes worldwide. In vivo evolution analysis identified drug resistance and metabolic adaptation mutations and their temporal dynamics during the patient's treatment course.
Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.
(Copyright © 2023 Rubinstein, Makhon, Losev, Valenci, Gatt, Margalit, Fass, Kutikov, Murik, Zeevi, Savyon, Tau, Kaidar Shwartz, Dveyrin, Rorman and Nissan.)
Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.
(Copyright © 2023 Rubinstein, Makhon, Losev, Valenci, Gatt, Margalit, Fass, Kutikov, Murik, Zeevi, Savyon, Tau, Kaidar Shwartz, Dveyrin, Rorman and Nissan.)