Contribution of a heparin-binding haemagglutinin interferon-gamma release assay to the detection of Mycobacterium tuberculosis infection in HIV-infected patients: comparison with the tuberculin skin test and the QuantiFERON®-TB Gold In-tube

BMC Infectious Diseases

Research Article

Marc Loyens¹  Camille Locht¹  Kinda Schepers²  Jean-Paul Van Vooren²  Jean-Christophe Goffard²  Charlotte Martin³  Marc Hildebrand⁴  Violette Dirix⁵  Myriam Libin⁵  Fanny Domont⁵  Françoise Mascart⁶  Chloé Wyndham-Thomas⁷ 

[1] INSERM U1019, Lille, France;CNRS UMR8204, Lille, France;Université Lille Nord de France, Lille, France;Center for Infection and Immunity of Lille, Institut Pasteur de Lille, Lille, France;Immunodeficiency unit, Hôpital Erasme, Brussels, Belgium;Infectious Disease, CHU Saint-Pierre, Brussels, Belgium;Infectious disease unit, IRIS SUD hospitals, Brussels, Belgium;Laboratory of Vaccinology and Mucosal Immunology, Université Libre de Bruxelles, Brussels, Belgium;Laboratory of Vaccinology and Mucosal Immunology, Université Libre de Bruxelles, Brussels, Belgium;Immunobiology Clinic, Hôpital Erasme, Brussels, Belgium;Laboratory of Vaccinology and Mucosal Immunology, Université Libre de Bruxelles, Brussels, Belgium;Immunodeficiency unit, Hôpital Erasme, Brussels, Belgium;

关键词: Active tuberculosis;    Heparin-binding haemagglutinin;    Human;    Human immunodeficiency virus;    Interferon-gamma release assay;    Latent tuberculosis;    Multiplex;    Mycobacterium tuberculosis;    QuantiFERON®-TB Gold In-Tube;    Tuberculin skin test;   

DOI  :  10.1186/s12879-015-0796-0

 received in 2014-04-09, accepted in 2015-02-03,  发布年份 2015

来源: Springer

【 摘 要 】

BackgroundThe screening and treatment of latent tuberculosis (TB) infection reduces the risk of progression to active disease and is currently recommended for HIV-infected patients. The aim of this study is to evaluate, in a low TB incidence setting, the potential contribution of an interferon-gamma release assay in response to the mycobacterial latency antigen Heparin-Binding Haemagglutinin (HBHA-IGRA), to the detection of Mycobacterium tuberculosis infection in HIV-infected patients.MethodsTreatment-naïve HIV-infected adults were recruited from 4 Brussels-based hospitals. Subjects underwent screening for latent TB using the HBHA-IGRA in parallel to a classical method consisting of medical history, chest X-ray, tuberculin skin test (TST) and QuantiFERON®-TB Gold In-Tube (QFT-GIT). Prospective clinical and biological follow-up ensued, with repeated testing with HBHA-IGRA. A group of HIV-infected patients with clinical suspicion of active TB was also recruited and tested with the HBHA-IGRA. Multiplex analysis was performed on the culture supernatants of this in-house assay to identify test read-outs alternative to interferon-gamma that could increase the sensitivity of the test.ResultsAmong 48 candidates enrolled for screening, 9 were identified with latent TB by TST and/or QFT-GIT results. Four of these 9 patients and an additional 3 screened positive with the HBHA-IGRA. This in-house assay identified all the patients that were positive for the TST and showed the best concordance with the presence of a M. tuberculosis exposure risk. During follow-up (median 14 months) no case of active TB was reported and HBHA-IGRA results remained globally constant. Fourteen HIV-infected patients with clinical suspicion of active TB were recruited. Active TB was confirmed for 6 of them among which 3 were HBHA-IGRA positive, each with very high interferon-gamma concentrations. All patients for whom active TB was finally excluded, including 2 non-tubercular mycobacterial infections, had negative HBHA-IGRA results. Multiplex analysis confirmed interferon-gamma as the best read-out.ConclusionsThe HBHA-IGRA appears complementary to the QuantiFERON®-TB Gold In-Tube for the screening of latent TB in HIV-infected patients. Large-scale studies are necessary to determine whether this combination offers sufficient sensitivity to dismiss TST, as suggested by our results. Furthermore, HBHA-IGRA may help in the diagnosis work-up of clinical suspicions of active TB.

【 授权许可】

Unknown   
© Wyndham-Thomas et al.; licensee BioMed Central. 2015. This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.