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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
Interpretation of Mycobacterium tuberculosis antigen-specific IFN-γ release assays (T-SPOT.TB) and factors that may modulate test results
Journal of Infection, Volume 55, No. 2, Year 2007
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Description
Background: Data about T cell antigen-specific (ESAT-6 and CFP-10) IFN-γ release assays (IGRAs) during and after completion of anti-tuberculous (TB) treatment are limited and highly discordant. Thus, the utility of IGRAs as a surrogate marker of mycobacterial burden remain unclear. Methods: To investigate factors that modulate IGRA responses during anti-TB treatment we used a standardised assay (T-SPOT.TB) in 33 patients with culture positive tuberculosis. Results: Significantly more patients in the early (≤4 months of anti-TB treatment) rather than the late phase (>4 months or completed anti-TB treatment) had positive IGRA responses [10/12 (83%) vs 4/21 (19%); p ≤ 0.01]. Thus, 17/21 (81%) in the late phase or who had completed treatment (mean duration of treatment = 8.7 months) were IGRA negative, despite having robust antigen-specific recall proliferative responses. In these 17 patients prolonged incubation (5 days vs overnight), use of different antigen preparations (protein vs peptide) and addition of endotoxin, failed to elicit positive responses. Conclusions: In treated TB patients the discordant IGRA data remain unexplained by variation in laboratory protocols and are more likely due to host or environmental factors. In a low burden setting IGRAs may be a promising surrogate marker of mycobacterial disease burden. © 2007.
Authors & Co-Authors
Dheda, Keertan U.J.
South Africa, Cape Town
University of Cape Town
United Kingdom, London
Ucl Medical School
Pooran, Anil S.
United Kingdom, London
Ucl Medical School
Pai, Madhukar
Canada, Montreal
Université Mcgill
Miller, R. F.
United Kingdom
University College Hospitals Nhs Trust
Lesley, K.
United Kingdom, London
Ucl Medical School
Booth, Helen L.
United Kingdom
University College Hospitals Nhs Trust
Scott, Geoffrey M.S.
United Kingdom
University College Hospitals Nhs Trust
Akbar, Arne N.
United Kingdom
University College Hospitals Nhs Trust
Zumla, A. I.
United Kingdom, London
Ucl Medical School
Rook, Graham A.W.
United Kingdom, London
Ucl Medical School
Statistics
Citations: 69
Authors: 10
Affiliations: 4
Identifiers
Doi:
10.1016/j.jinf.2007.02.005
ISSN:
01634453
Research Areas
Infectious Diseases