RT Journal Article
SR Electronic
T1 Evaluation of the accuracy of several immune experimental diagnostic tools to distinguish active tuberculosis from latent infection
JF European Respiratory Journal
JO Eur Respir J
FD European Respiratory Society
SP OA3486
DO 10.1183/13993003.congress-2015.OA3486
VO 46
IS suppl 59
A1 Petruccioli, Elisa
A1 Petrone, Linda
A1 Chiacchio, Teresa
A1 Vanini, Valentina
A1 Palmieri, Fabrizio
A1 Gualano, Gina
A1 Cuzzi, Gilda
A1 Navarra, Assunta
A1 Girardi, Enrico
A1 Goletti, Delia
YR 2015
UL http://erj.ersjournals.com/content/46/suppl_59/OA3486.abstract
AB Background: There is still not reliable tests to distinguish active tuberculosis (TB) from latent TB infection (LTBI) by an immune diagnostic test. QuantiFERON TB Gold (QFT) is used for LTBI diagnosis; however this test does not distinguish between LTBI and active TB. Recently, assays based on the response to antigens of latency as HBHA or Rv2628, or evaluation on RD1-specific T cells by cytometry of the modulation of the effector memory/central memory status has been evaluated.Aim: To evaluate in a low TB endemic country as Italy, the accuracy to discriminate active TB from LTBI using several immune diagnostic tests based on different TB antigens and on the modulation of the T cell effector memory status.Methods: Evaluation of the accuracy to distinguish active TB from LTBI in several cohorts of QFT-IT-positive subjects either HIV-uninfected (107) or HIV-infected subjects (27) with active TB, LTBI or enrolled as cured TB. Whole blood or peripheral blood cells were stimulated with RD1 and latency antigens. Interferon (IFN)-γ response was evaluated by ELISA and mono-polyfunctional cytokine expression (IFN-γ, IL-2, TNF-α) and differentiation markers by cytometry.Results: To predict active TB we used the combination of the different experimental-immune-based approaches by logistic regression followed by ROC analysis (AUC 0.96; 95% CI, 0.87-0.99, p<0.0001). We then identified a cut-off which led to an accuracy of 92.3% sensitivity and 95.2% specificity.Conclusions: This study proposes that a combination of several experimental approaches may help to distinguish TB disease from LTBI in a low TB endemic country.