Utility of host markers detected in Quantiferon supernatants for the diagnosis of tuberculosis in children in a high-burden setting
Date
2013-05-15
Journal Title
Journal ISSN
Volume Title
Publisher
PLoS
Abstract
Background: The diagnosis of childhood tuberculosis (TB) disease remains a challenge especially in young and HIV-infected
children. Recent studies have identified potential host markers which, when measured in Quantiferon (QFT-IT) supernatants,
show promise in discriminating between Mycobacterium tuberculosis (M.tb) infection states. In this study, the utility of such
markers was investigated in children screened for TB in a setting with high TB incidence.
Methodology and Principal Findings: 76 children (29% HIV-infected) with or without active TB provided blood specimens
collected directly into QFT-IT tubes. After overnight incubation, culture supernatants were harvested, aliquoted and frozen
for future immunological research purposes. Subsequently, the levels of 12 host markers previously identified as potential
TB diagnostic markers were evaluated in these supernatants for their ability to discriminate between M.tb infection and
disease states using the Luminex platform. Of the 76 children included, 19 (25%) had culture confirmed TB disease; 26 (46%)
of the 57 without TB had positive markers of M.tb infection defined by a positive QFT-IT test. The potentially most useful
analytes for diagnosing TB disease included IFN-a2, IL-1Ra, sCD40L and VEGF and the most useful markers for discriminating
between QFT-IT positive children as TB or latent infection included IL-1Ra, IP-10 and VEGF. When markers were used in
combinations of four, 84% of all children were accurately classified into their respective groups (TB disease or no TB), after
leave-one-out cross validation.
Conclusions: Measurement of the levels of IFN-a2, IL-1Ra, sCD40L, IP-10 and VEGF in QFT-IT supernatants may be a useful
method for diagnosing TB disease and differentiating between active TB disease and M.tb infection in children. Our
observations warrant further investigation in larger well-characterized clinical cohorts.
Description
CITATION: Chegou, N. N. et al. 2013. Utility of host markers detected in Quantiferon
supernatants for the diagnosis of tuberculosis in
children in a high-burden setting. PLoS ONE, 8(5):e64226, doi:10.1371/journal.pone.0064226.
The original publication is available at http://journals.plos.org/plosone
The original publication is available at http://journals.plos.org/plosone
Keywords
Quantiferon supernatants, Tuberculosis in children -- Diagnosis -- South Africa, HIV-positive children, Tuberculosis -- Diagnosis -- Tools
Citation
Chegou, N. N. et al. 2013. Utility of host markers detected in Quantiferon
supernatants for the diagnosis of tuberculosis in
children in a high-burden setting. PLoS ONE, 8(5):e64226, doi:10.1371/journal.pone.0064226.