Ultrasensitive Molecular Assay Detects Hidden Tuberculosis DNA in Sixteen Percent of Hospitalized Boston Patients

Boston University researchers use a new molecular assay to find hidden TB DNA in 16% of patients, revealing a potential link to sickle cell complications.

By: AXL Media

Published: Apr 14, 2026, 11:39 AM EDT

Source: Information for this report was sourced from EurekAlert!

Uncovering a Hidden Pathogen in Urban Centers

A landmark study from Boston University’s National Emerging Infectious Diseases Laboratories (NEIDL) has challenged long-standing assumptions about the prevalence of tuberculosis in the United States. Utilizing an ultrasensitive molecular tool known as the Totally Optimized PCR (TOP) TB assay, researchers screened respiratory samples from patients at Boston Medical Center and St. Elizabeth's Medical Center. The results revealed that between 12 and 16 percent of predominantly U.S.-born patients carried Mycobacterium tuberculosis DNA, a figure far exceeding the expected rate for a city with a low incidence of active TB. These findings suggest that the respiratory pathogen may be significantly underdiagnosed by traditional medical protocols.

The Sickle Cell and Acute Chest Syndrome Link

Among the most significant discoveries in the report is a striking correlation between tuberculosis DNA and acute chest syndrome, a critical complication of sickle cell disease. According to the research team, all three patients diagnosed with the syndrome during the study period tested positive for the TB pathogen's genetic material. This potential association suggests that hidden tuberculosis infections could be a contributing factor or a primary trigger for severe pulmonary crises in sickle cell patients. Dr. Edward C. Jones-López noted that if these results are confirmed in larger trials, they could revolutionize how clinicians manage complications for this vulnerable patient population.

Limitations of Conventional Diagnostic Methods

The disparity between the TOP TB assay results and standard medical tests highlights a critical gap in current infectious disease detection. Most of the patients who tested positive for TB DNA had previously yielded negative results on standard mycobacterial cultures and interferon-gamma release assays. Unlike conventional cultures that require live, actively growing bacteria to produce a positive result, the TOP assay targets a specific gene involved in the assembly of the bacterial cell wall, allowing for the detection of non-viable or dormant genetic material. This ability to find "hidden" forms of the disease suggests that thousands of Americans may be carrying infections that current tools simply cannot see.