Publications by authors named "Rahul Lokhande"
Background: Transmission is contributing to the slow decline of tuberculosis (TB) incidence globally. Drivers of TB transmission in India, the country estimated to carry a quarter of the World's burden, are not well studied. We conducted a genomic epidemiology study to compare epidemiological success, host factors and drug resistance (DR) among the four major Mycobacterium tuberculosis (Mtb) lineages (L1-4) circulating in Pune, India.
View Article and Find Full Text PDFEarlier biomarkers of pulmonary tuberculosis (PTB) treatment outcomes are critical to monitor shortened anti-TB treatment (ATT). To identify early microbiologic markers of unfavorable TB treatment outcomes. We performed a subanalysis of 2 prospective TB cohort studies conducted from 2013 to 2019 in India.
View Article and Find Full Text PDFThere is great need for vaccines against tuberculosis (TB) more efficacious than the licensed BCG. Our goal was to identify new vaccine benchmarks by identifying immune responses that distinguish individuals able to eradicate the infection (TB-resisters) from individuals with latent infection (LTBI-participants). TB-resisters had higher frequencies of circulating CD8 glucose monomycolate (GMM)+ Granzyme-B+ T cells than LTBI-participants and higher proportions of polyfunctional conventional and nonconventional T cells expressing Granzyme-B and/or PD-1 after stimulation of blood mononuclear cells.
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- - The study investigated how sex differences affect tuberculosis (TB) severity, drug exposure, and treatment outcomes, revealing that women generally have a lower mycobacterial burden and face fewer unfavorable treatment outcomes than men.
- - Conducted in India with 1,541 participants, women had a significantly lower risk (35%) of treatment failure or recurrence, with specific factors like cavitary disease increasing risk for women, while men were impacted more by alcohol use and other health metrics.
- - Women demonstrated higher drug exposure levels for isoniazid compared to men, emphasizing the importance of considering sex differences when developing strategies to enhance TB treatment effectiveness.
Background: Despite antiretroviral therapy, chronic lung diseases remain an important source of morbidity and mortality in people with HIV (PWH). We sought to identify clinical and immunological markers of pulmonary impairment among PWH in India.
Methods: Two hundred ten adult PWH receiving antiretroviral therapy (ART) were prospectively evaluated for 3 years.
Article Synopsis
- This study investigates how diabetes mellitus (DM) affects the mutation rate and recurrence of Mycobacterium tuberculosis (Mtb) in TB patients in India by comparing isolates from those with and without DM.
- Out of 1,633 enrolled participants, 236 had confirmed TB treatment failure/recurrence, with whole genome sequencing performed on 76 Mtb isolate pairs to analyze mutations.
- Results indicate that TB patients with DM had significantly higher mutation rates during recurrence compared to those without DM, and one-fourth of the DM patients experienced exogenous reinfection.
Diabetes Mellitus and Tuberculosis Treatment Outcomes in Pune, India.
Open Forum Infect Dis
April 2021
Article Synopsis
- Diabetes mellitus (DM) increases the risk of tuberculosis (TB), and a study in India compared treatment outcomes between TB patients with and without DM over 18 months.
- Among 799 participants, those with DM had a similar overall rate of unfavorable treatment outcomes (20% for TB-DM vs 21% for TB-only), but had higher mortality rates.
- The study highlighted that early mortality was significantly higher for TB patients with DM, suggesting a need for interventions to improve outcomes for this group.
The World Health Organization (WHO) recently changed its guidance for tuberculosis (TB) preventive treatment (TPT) recommending TPT for all pulmonary TB (PTB) exposed household contacts (HHC) to prevent incident TB disease (iTBD), regardless of TB infection (TBI) status. However, this recommendation was conditional as the strength of evidence was not strong. We assessed risk factors for iTBD in recently-exposed adult and pediatric Indian HHC, to determine which HHC subgroups might benefit most from TPT.
View Article and Find Full Text PDFLipid mediators of inflammation and Resolution in individuals with tuberculosis and tuberculosis-Diabetes.
Prostaglandins Other Lipid Mediat
April 2020
Article Synopsis
- * A study involving 40 individuals (20 with newly diagnosed DM and 20 without) analyzed serum samples to quantify pro-inflammatory and pro-resolving lipid mediators, identifying specific lipid families that are abundant in each group.
- * Findings revealed that individuals with TB-DM exhibited stronger connections between pro-inflammatory and pro-resolving lipid mediators than those with TB alone, suggesting a complex molecular balance at play in this comorbidity.
Background: Household contacts (HHCs) of TB patients are at high risk of developing evidence of latent TB infection (LTBI) and active disease from the index patient. We estimated the age-specific prevalence of LTBI and the force of infection (FI), as a measure of recent transmission, among HHCs of active TB patients.
Methods: A cross-sectional analysis of HHCs of pulmonary TB patients enrolled in a prospective study, 'CTRIUMPh', was conducted at two sites in India.
Background: Burden, phenotype and risk-factors of lung function defects in successfully treated tuberculosis cases are unclear.
Methods: We performed spirometry with bronchodilators in new drug-sensitive adult (≥18 years) pulmonary tuberculosis cases during the 12 months following successful treatment in India. Airflow obstruction was defined as pre-bronchodilator FEV1/FVC<5th percentile of Global Lung Initiative mixed-ethnicity reference (lower limit of normal [LLN]).
Article Synopsis
- Diabetes mellitus (DM) and tuberculosis (TB) are increasingly overlapping diseases, and their interaction can affect how well TB treatments work.
- A study involving 243 TB patients found that those with DM had lower concentrations of the anti-TB drug pyrazinamide, which can impede treatment effectiveness, particularly if HbA1c levels are high.
- Higher concentrations of isoniazid or rifampin did improve treatment outcomes for DM patients, but high pyrazinamide levels led to worse outcomes like treatment failure or relapse.
Background: Diabetes mellitus (DM) increases tuberculosis (TB) risk, and there is increasing concern over the public health implications of the convergence of these two epidemics. Screening for TB among people with DM is now recommended in India.
Methods: People with DM seeking care at a large public sector tertiary care hospital clinic in Pune, India, were screened for TB from June 2015 to May 2016.
The present study was undertaken to detect Pneumocystis jirovecii infection among HIV-positive patients presenting with symptoms of lower respiratory tract infection and analyze the associated dihydropteroate synthase (DHPS) and dihydrofolate reductase (DHFR) mutations. P. jirovecii infection was detected in 12.
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