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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
Detection of tuberculosis in HIV-infected children using an enzyme-linked immunospot assay
AIDS, Volume 23, No. 8, Year 2009
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Description
Objective: To evaluate an enzyme-linked immunospot assay (ELISPOT) for the diagnosis of tuberculosis (TB) in HIV-infected children with suspected TB and to compare the performance of ELISPOT with the tuberculin skin test (TST). Methods: Interferon-γ responses to Mycobacterium tuberculosis-specific antigens were measured by ELISPOT in HIV-infected children with suspected TB. HIV-infected and HIV-uninfected children without TB were taken for comparison. Results: Results were available for 188 children, of whom 139 (74%) were HIV-infected. Of these, 22 were classified as having definite TB: 24 probable TB, 14 possible TB and 128 not having TB. The median (range) age of patients was 20 (10-54.1) months. Median interferon-γ responses to early-secreted antigenic target-6 and culture filtrate protein-10 were higher in children with definite or probable TB compared with children without TB (P<0.002). In HIV-infected children with an interpretable ELISPOT result, the ELISPOT was positive in 14/21 (66%) with definite TB. A significantly higher proportion of HIV-infected children with definite or probable TB had a positive ELISPOT compared with a positive TST [25/39 (64%) vs. 10/34 (29%), P=0.005]. In contrast to TST, results from ELISPOT were not affected by young age or severe immunosuppression. In HIV-infected children without active TB disease, 27% had a positive ELISPOT, suggesting latent TB infection. Conclusion: ELISPOT is more sensitive than TST for the detection of active TB in HIV-infected children. However, the sensitivity of current ELISPOT assays is not sufficiently high to be used as a rule out test for TB. © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins.
Authors & Co-Authors
Davies, M. A.
South Africa, Cape Town
University of Cape Town
Connell, Tom G.
Australia, Melbourne
University of Melbourne
Australia, Melbourne
Royal Children's Hospital, Melbourne
South Africa, Cape Town
University of Cape Town
Johannisen, Christine
South Africa, Cape Town
University of Cape Town
Wood, Kathryn
South Africa, Cape Town
University of Cape Town
Pienaar, Sandra M.
South Africa, Cape Town
University of Cape Town
Andrea Wilkinson, Katalin Andrea
South Africa, Cape Town
University of Cape Town
United States, Hampstead
National Institute for Medical Research
Wilkinson, Robert J.
South Africa, Cape Town
University of Cape Town
United States, Hampstead
National Institute for Medical Research
United Kingdom, London
Imperial College London
Zar, Heather J.
South Africa, Cape Town
University of Cape Town
Eley, Brian S.
South Africa, Cape Town
University of Cape Town
Beatty, David W.
South Africa, Cape Town
University of Cape Town
Curtis, Nigel C.
Australia, Melbourne
University of Melbourne
Australia, Melbourne
Royal Children's Hospital, Melbourne
NicoI, Mark P.
South Africa, Cape Town
University of Cape Town
Statistics
Citations: 46
Authors: 12
Affiliations: 5
Identifiers
Doi:
10.1097/QAD.0b013e32832956ad
e-ISSN:
14735571
Research Areas
Infectious Diseases
Maternal And Child Health