IP-10 is an additional marker for tuberculosis (TB) detection in HIV-infected persons in a low-TB endemic country

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• 作者：Valentina Vanini^a ; Elisa Petruccioli^a ; Cristiana Gioia^b ; Gilda Cuzzi^a ; Nicoletta Orchi^c ; Alessia Rianda^d ; Lucia Alba^d ; Maria Letizia Giancola^d ; Aristide Conte^d ; Vincenzo Schininà ; ^e ; Elisa Busi Rizzi^e ; Enrico Girardi^c ; Delia Goletti^a ; ^{delia.goletti@inmi.it}
• 关键词：IP-10 ; Tuberculosis ; HIV ; QuantiFERON ; IGRA ; Immune deficiency ; Diagnosis ; Low TB endemic country
• 刊名：Journal of Infection
• 出版年：2012
• 期刊代码：6_01634453
• 类别：imm
• 出版时间：July, 2012
• 卷：65
• 期：1
• 页码：49-59
• 文件大小：416 K

摘要

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Summary

Objective

In Indian HIV-infected patients, IP-10 response to QuantiFERON-TB Gold In tube (QFT-IT) antigens has been associated to tuberculosis (TB). However, specificity for active TB was lower than that reported by QFT-IT, making accuracy for TB detection questionable. To investigate this uncertainty, likely due to India being highly endemic for TB, and to better identify TB correlates, we evaluated the IP-10-based assay in HIV-infected subjects in Italy, a low-TB endemic country.

Methods

195 individuals were prospectively enrolled; 118 were HIV-infected (21 with active TB, 97 without active TB, and distinguished as high/low-TB-risk). QFT-IT was performed and IP-10 was evaluated by ELISA.

Results

Among the HIV-infected individuals, sensitivity for active TB was 66.7%by IP-10-based test and 52.4%(p聽=聽1) by QFT-IT. IP-10-based assay showed a lower dependence on mitogen-response and CD4 counts than QFT-IT. Among subjects without active TB, a higher proportion of IP-10 responders was shown in high-TB-risk subjects than low-TB-risk subjects (40.0%vs 12.9%), similar to QFT-IT (37.1%vs 4.8%). Low-TB risk subjects showed 87.1%specificity for active TB by IP-10-based test vs 95.2%by QFT-IT.

Conclusions

In a low-TB endemic country, besides IFN-纬, IP-10 response to QFT-IT is associated with active TB and TB risk factors in HIV-infected patients with lower dependence on mitogen-response and CD4 counts.