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Diagnostic performance of blood inflammatory markers for tuberculosis screening in people living with HIV.

التفاصيل البيبلوغرافية
العنوان: Diagnostic performance of blood inflammatory markers for tuberculosis screening in people living with HIV.
المؤلفون: Katherine Farr, Resmi Ravindran, Luke Strnad, Emily Chang, Lelia H Chaisson, Christina Yoon, William Worodria, Alfred Andama, Irene Ayakaka, Priscilla Bbosa Nalwanga, Patrick Byanyima, Nelson Kalema, Sylvia Kaswabuli, Winceslaus Katagira, Kyomugisha Denise Aman, Emmanuel Musisi, Nuwagaba Wallen Tumwine, Ingvar Sanyu, Robert Ssebunya, J Lucian Davis, Laurence Huang, Imran H Khan, Adithya Cattamanchi
المصدر: PLoS ONE, Vol 13, Iss 10, p e0206119 (2018)
بيانات النشر: Public Library of Science (PLoS), 2018.
سنة النشر: 2018
المجموعة: LCC:Medicine
LCC:Science
مصطلحات موضوعية: Medicine, Science
الوصف: BACKGROUND:Approaches to screening for active tuberculosis (TB) among people living with HIV are inadequate, leading to missed diagnoses and poor implementation of preventive therapy. METHODS:Consecutive HIV-infected adults hospitalized at Mulago Hospital (Kampala, Uganda) between June 2011 and July 2013 with a cough ≥ 2 weeks were enrolled. Patients underwent extensive evaluation for pulmonary TB. Concentrations of 43 cytokines/chemokines were measured at the same time point as C-reactive protein (CRP) in banked plasma samples using commercially-available multiplex kits. Advanced classification algorithms were used to rank cytokines/chemokines for their ability to identify TB, and to model the specificity of the top-ranked cytokines/chemokines individually and in combination with sensitivity constrained to ≥ 90% as recommended for TB screening. RESULTS:The median plasma level of 5 biomarkers (IL-6, INF-γ, MIG, CRP, IL-18) was significantly different between patients with and without TB. With sensitivity constrained to 90%, all had low specificity with IL-6 showing the highest specificity (44%; 95% CI 37.4-49.5). Biomarker panels were found to be more valuable than any biomarker alone. A panel combining IFN-γ and IL-6 had the highest specificity (50%; 95% CI 46.7-53.3). Sensitivity remained high (>85%) for all panels among sputum smear-negative TB patients. CONCLUSIONS:Direct measurement of unstimulated plasma cytokines/chemokines in peripheral blood is a promising approach to TB screening. Cytokine/chemokine panels retained high sensitivity for smear-negative TB and achieved improved specificity compared to individual cytokines/chemokines. These markers should be further evaluated in outpatient settings where most TB screening occurs and where other illnesses associated with systematic inflammation are less common.
نوع الوثيقة: article
وصف الملف: electronic resource
اللغة: English
تدمد: 1932-6203
Relation: http://europepmc.org/articles/PMC6198956?pdf=render; https://doaj.org/toc/1932-6203
DOI: 10.1371/journal.pone.0206119
URL الوصول: https://doaj.org/article/589f8a35a21c4504aa7ff8080f7331c8
رقم الأكسشن: edsdoj.589f8a35a21c4504aa7ff8080f7331c8
قاعدة البيانات: Directory of Open Access Journals
الوصف
تدمد:19326203
DOI:10.1371/journal.pone.0206119