Rapid diagnosis of new and relapse tuberculosis by quantification of a circulating antigen in HIV-infected adults in the Greater Houston metropolitan area
Abstract Background HIV-associated immune defects inhibit tuberculosis (TB) diagnosis, promote development of extrapulmonary TB and paucibacillary pulmonary TB cases with atypical radiographic features, and increase TB relapse rates. We therefore assessed the diagnostic performance of a novel assay...
Main Authors: | , , , , , , , |
---|---|
Format: | Article |
Language: | English |
Published: |
BMC
2017-11-01
|
Series: | BMC Medicine |
Subjects: | |
Online Access: | http://link.springer.com/article/10.1186/s12916-017-0952-z |
id |
doaj-e1d160515883404aa78649b05a72b2c8 |
---|---|
record_format |
Article |
spelling |
doaj-e1d160515883404aa78649b05a72b2c82020-11-24T23:06:48ZengBMCBMC Medicine1741-70152017-11-0115111010.1186/s12916-017-0952-zRapid diagnosis of new and relapse tuberculosis by quantification of a circulating antigen in HIV-infected adults in the Greater Houston metropolitan areaJia Fan0Hedong Zhang1Duc T. Nguyen2Christopher J. Lyon3Charles D. Mitchell4Zhen Zhao5Edward A. Graviss6Ye Hu7School of Biological and Health Systems Engineering, Virginia G. Piper Biodesign Center for Personalized Diagnostics, The Biodesign Institute, Arizona State UniversityDepartment of Nanomedicine, Houston Methodist Research InstituteDepartment of Pathology and Genomic Medicine, Houston Methodist Research InstituteSchool of Biological and Health Systems Engineering, Virginia G. Piper Biodesign Center for Personalized Diagnostics, The Biodesign Institute, Arizona State UniversityUniversity of Miami, Leonard M. Miller School of MedicineDepartment of Laboratory Medicine, Clinical Center, National Institutes of HealthDepartment of Pathology and Genomic Medicine, Houston Methodist Research InstituteSchool of Biological and Health Systems Engineering, Virginia G. Piper Biodesign Center for Personalized Diagnostics, The Biodesign Institute, Arizona State UniversityAbstract Background HIV-associated immune defects inhibit tuberculosis (TB) diagnosis, promote development of extrapulmonary TB and paucibacillary pulmonary TB cases with atypical radiographic features, and increase TB relapse rates. We therefore assessed the diagnostic performance of a novel assay that directly quantitates serum levels of the Mycobacterium tuberculosis (Mtb) virulence factor 10-kDa culture filtrate protein (CFP-10) to overcome limitations associated with detecting Mtb bacilli in sputum or tissue biopsies. Methods This study analyzed HIV-positive adults enrolled in a large, population-based TB screening and surveillance project, the Houston Tuberculosis Initiative, between October 1995 and September 2004, and assigned case designations using standardized criteria. Serum samples were trypsin-digested and immunoprecipitated for an Mtb-specific peptide of CFP-10 that was quantified by liquid chromatography-mass spectrometry for rapid and sensitive TB diagnosis. Results Among the 1053 enrolled patients, 110 met all inclusion criteria; they included 60 tuberculosis cases (12 culture-negative TB), including 9 relapse TB cases, and 50 non-TB controls, including 15 cases with history of TB. Serum CFP-10 levels diagnosed 89.6% (77.3–96.5) and 66.7% (34.9–90.1) of culture-positive and culture-negative TB cases, respectively, and exhibited 88% (75.7–95.5) diagnostic specificity in all non-TB controls. Serum antigen detection and culture, respectively, identified 85% (73.4–92.9) and 80.0% (67.3–88.8) of all 60 TB cases. Conclusions Quantitation of the Mtb virulence factor CFP-10 in serum samples of HIV-infected subjects diagnosed active TB cases with high sensitivity and specificity and detected cases missed by the gold standard of Mtb culture. These results suggest that serum CFP-10 quantitation holds great promise for the rapid diagnosis of suspected TB cases in patients who are HIV-infected.http://link.springer.com/article/10.1186/s12916-017-0952-zHIVMycobacterium tuberculosisCo-infectionDiagnosisBlood testCFP-10 |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Jia Fan Hedong Zhang Duc T. Nguyen Christopher J. Lyon Charles D. Mitchell Zhen Zhao Edward A. Graviss Ye Hu |
spellingShingle |
Jia Fan Hedong Zhang Duc T. Nguyen Christopher J. Lyon Charles D. Mitchell Zhen Zhao Edward A. Graviss Ye Hu Rapid diagnosis of new and relapse tuberculosis by quantification of a circulating antigen in HIV-infected adults in the Greater Houston metropolitan area BMC Medicine HIV Mycobacterium tuberculosis Co-infection Diagnosis Blood test CFP-10 |
author_facet |
Jia Fan Hedong Zhang Duc T. Nguyen Christopher J. Lyon Charles D. Mitchell Zhen Zhao Edward A. Graviss Ye Hu |
author_sort |
Jia Fan |
title |
Rapid diagnosis of new and relapse tuberculosis by quantification of a circulating antigen in HIV-infected adults in the Greater Houston metropolitan area |
title_short |
Rapid diagnosis of new and relapse tuberculosis by quantification of a circulating antigen in HIV-infected adults in the Greater Houston metropolitan area |
title_full |
Rapid diagnosis of new and relapse tuberculosis by quantification of a circulating antigen in HIV-infected adults in the Greater Houston metropolitan area |
title_fullStr |
Rapid diagnosis of new and relapse tuberculosis by quantification of a circulating antigen in HIV-infected adults in the Greater Houston metropolitan area |
title_full_unstemmed |
Rapid diagnosis of new and relapse tuberculosis by quantification of a circulating antigen in HIV-infected adults in the Greater Houston metropolitan area |
title_sort |
rapid diagnosis of new and relapse tuberculosis by quantification of a circulating antigen in hiv-infected adults in the greater houston metropolitan area |
publisher |
BMC |
series |
BMC Medicine |
issn |
1741-7015 |
publishDate |
2017-11-01 |
description |
Abstract Background HIV-associated immune defects inhibit tuberculosis (TB) diagnosis, promote development of extrapulmonary TB and paucibacillary pulmonary TB cases with atypical radiographic features, and increase TB relapse rates. We therefore assessed the diagnostic performance of a novel assay that directly quantitates serum levels of the Mycobacterium tuberculosis (Mtb) virulence factor 10-kDa culture filtrate protein (CFP-10) to overcome limitations associated with detecting Mtb bacilli in sputum or tissue biopsies. Methods This study analyzed HIV-positive adults enrolled in a large, population-based TB screening and surveillance project, the Houston Tuberculosis Initiative, between October 1995 and September 2004, and assigned case designations using standardized criteria. Serum samples were trypsin-digested and immunoprecipitated for an Mtb-specific peptide of CFP-10 that was quantified by liquid chromatography-mass spectrometry for rapid and sensitive TB diagnosis. Results Among the 1053 enrolled patients, 110 met all inclusion criteria; they included 60 tuberculosis cases (12 culture-negative TB), including 9 relapse TB cases, and 50 non-TB controls, including 15 cases with history of TB. Serum CFP-10 levels diagnosed 89.6% (77.3–96.5) and 66.7% (34.9–90.1) of culture-positive and culture-negative TB cases, respectively, and exhibited 88% (75.7–95.5) diagnostic specificity in all non-TB controls. Serum antigen detection and culture, respectively, identified 85% (73.4–92.9) and 80.0% (67.3–88.8) of all 60 TB cases. Conclusions Quantitation of the Mtb virulence factor CFP-10 in serum samples of HIV-infected subjects diagnosed active TB cases with high sensitivity and specificity and detected cases missed by the gold standard of Mtb culture. These results suggest that serum CFP-10 quantitation holds great promise for the rapid diagnosis of suspected TB cases in patients who are HIV-infected. |
topic |
HIV Mycobacterium tuberculosis Co-infection Diagnosis Blood test CFP-10 |
url |
http://link.springer.com/article/10.1186/s12916-017-0952-z |
work_keys_str_mv |
AT jiafan rapiddiagnosisofnewandrelapsetuberculosisbyquantificationofacirculatingantigeninhivinfectedadultsinthegreaterhoustonmetropolitanarea AT hedongzhang rapiddiagnosisofnewandrelapsetuberculosisbyquantificationofacirculatingantigeninhivinfectedadultsinthegreaterhoustonmetropolitanarea AT ductnguyen rapiddiagnosisofnewandrelapsetuberculosisbyquantificationofacirculatingantigeninhivinfectedadultsinthegreaterhoustonmetropolitanarea AT christopherjlyon rapiddiagnosisofnewandrelapsetuberculosisbyquantificationofacirculatingantigeninhivinfectedadultsinthegreaterhoustonmetropolitanarea AT charlesdmitchell rapiddiagnosisofnewandrelapsetuberculosisbyquantificationofacirculatingantigeninhivinfectedadultsinthegreaterhoustonmetropolitanarea AT zhenzhao rapiddiagnosisofnewandrelapsetuberculosisbyquantificationofacirculatingantigeninhivinfectedadultsinthegreaterhoustonmetropolitanarea AT edwardagraviss rapiddiagnosisofnewandrelapsetuberculosisbyquantificationofacirculatingantigeninhivinfectedadultsinthegreaterhoustonmetropolitanarea AT yehu rapiddiagnosisofnewandrelapsetuberculosisbyquantificationofacirculatingantigeninhivinfectedadultsinthegreaterhoustonmetropolitanarea |
_version_ |
1725620990921146368 |