Time to Reactivation of Latent Tuberculosis Infection Varies by Lineage

Infection by Mycobacterium tuberculosis complex (MTB) produces either active tuberculosis (TB) disease or latent infections without symptoms with about a 10% lifetime risk of developing disease. We hypothesize that MTB lineages may have different latent reactivation phenotypes, and that these different phenotypes would be reflected in different disease dynamics in foreign-born TB patients in New York City (NY). We define the time to disease (TTD) as the length of time between a subject's arrival in the US and development of active disease. We study statistical differences in TTD distributions for the four most prevalent MTB lineages. By studying foreign-born patients with unique genotype MTB, TTD can serve as a proxy for time to latent reactivation. We observe significant differences between the TTD distributions among the 4 lineages using the Anderson-Darling (AD) test. Deeper understanding of latent reactivation can support TB control efforts and aid development of new tuberculosis drugs targeted toward latent TB.