Serological markers predicting tuberculosis in human immunodeficiency virus-infected patients
Abstract:SETTING: Human immunodeficiency virus (HIV)-positive patients retrospectively identified at the Hospital of Bari, Italy, with diagnosis of tuberculosis (TB) (n = 30) or non-tuberculous pneumonia (n = 29). Serum samples drawn at the time of diagnosis and one year before. Anti-purified protein derivative (PPD) and anti-diacyltrehalose (DAT) serum antibodies quantified by ELISA assay.
OBJECTIVE: Since TB patients with HIV infection may present with elevated serum antibodies against Mycobacterium tuberculosis, we hypothesized that TB-specific antibody markers might predict TB in these subjects.
DESIGN: A retrospective study was designed to assess the presence of M. tuberculosis-specific antibodies in HIV-positive patients developing TB.
RESULTS: Of 30 HIV-positive TB patients, 24 (80%) had anti-PPD or anti-DAT antibodies at the time of TB diagnosis, and 20 (67%) one year before. In a subpopulation of 16 of the 30 HIV-positive subjects, positivity for anti-PPD or anti-DAT antibodies one year before TB diagnosis was higher (11/16, 69%) than for the PPD skin test (4/16, 25%, P < 0.01). Antibody tests were specific for TB since positivity rates were lower both in patients with non-tuberculous pneumonia (P < 0.01) and in those with M. avium infection (P < 0.05).
CONCLUSION: Antibody markers may predict TB in HIV-positive subjects, including those with negative PPD skin test.
Document Type: Regular Paper
Affiliations: 1: Department of Medical Sciences, Respiratory Disease Section, University of Modena, Modena, Italy 2: Institute of Infectious Diseases, University of Bari, Bari, Italy 3: Ospedale Sesto San Giovanni, Milano, Italy 4: Department of Biomedical Sciences, University of Modena, Modena, Italy 5: Istituto Superiore di Sanitã, Roma, Italy
Publication date: October 1, 1997
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