This study was carried out at Tongji Hospital (Qiaokou cohort, the largest hospital in central China) and Sino-French New City Hospital (Caidian cohort, a branch hospital of Tongji Hospital). Subjects in Qiaokou cohort were enrolled between January 2013 and October 2019; and those in Caidian cohort were enrolled from January 2017 to October 2019. All participants were recruited based on positive T-SPOT results. BRE was performed in all subjects simultaneously. ATB was diagnosed as having positive results of Xpert MTB/RIF, and/or Mtb culture (Mycobacterial Growth Indicator Tube 960 and Lowenstein-Jensen media) in sputum, bronchoalveolar lavage fluid, or biopsy tissue, with clinical symptoms and radiological characteristics suggestive of TB. Individuals with positive T-SPOT results but without clinical or radiographic evidence of ATB were defined as LTBI. The exclusion criteria were as follows: (1) patients younger than 17 years of age and (2) patients undergoing anti-TB treatment. This study was approved by the Ethics Committee of Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.

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