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

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Abstract

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 = 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-γ, 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.

Original languageEnglish
Pages (from-to)49-59
Number of pages11
JournalJournal of Infection
Volume65
Issue number1
DOIs
Publication statusPublished - Jul 2012

Keywords

  • Diagnosis
  • HIV
  • IGRA
  • Immune deficiency
  • IP-10
  • Low TB endemic country
  • QuantiFERON
  • Tuberculosis

ASJC Scopus subject areas

  • Microbiology (medical)
  • Infectious Diseases

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