IP-10 是低结核流行国家中 HIV 感染者结核检测的附加标志物。
IP-10 is an additional marker for tuberculosis (TB) detection in HIV-infected persons in a low-TB endemic country.
机构信息
Translational Research Unit, Department of Epidemiology and Preclinical Research, L. Spallanzani National Institute for Infectious Diseases (INMI), IRCCS, Via Portuense 292, 00149 Rome, Italy.
出版信息
J Infect. 2012 Jul;65(1):49-59. doi: 10.1016/j.jinf.2012.03.017. Epub 2012 Mar 29.
OBJECTIVE
In Indian HIV-infected patients, IP-10 response to QuantiFERON-TB Gold In tube (QFT-IT) antigens has been associated to tuberculosis (TB). However, specificity for active TB was lower than that reported by QFT-IT, making accuracy for TB detection questionable. To investigate this uncertainty, likely due to India being highly endemic for TB, and to better identify TB correlates, we evaluated the IP-10-based assay in HIV-infected subjects in Italy, a low-TB endemic country.
METHODS
195 individuals were prospectively enrolled; 118 were HIV-infected (21 with active TB, 97 without active TB, and distinguished as high/low-TB-risk). QFT-IT was performed and IP-10 was evaluated by ELISA.
RESULTS
Among the HIV-infected individuals, sensitivity for active TB was 66.7% by IP-10-based test and 52.4% (p = 1) by QFT-IT. IP-10-based assay showed a lower dependence on mitogen-response and CD4 counts than QFT-IT. Among subjects without active TB, a higher proportion of IP-10 responders was shown in high-TB-risk subjects than low-TB-risk subjects (40.0% vs 12.9%), similar to QFT-IT (37.1% vs 4.8%). Low-TB risk subjects showed 87.1% specificity for active TB by IP-10-based test vs 95.2% by QFT-IT.
CONCLUSIONS
In a low-TB endemic country, besides IFN-γ, IP-10 response to QFT-IT is associated with active TB and TB risk factors in HIV-infected patients with lower dependence on mitogen-response and CD4 counts.
目的
在印度感染 HIV 的患者中，干扰素诱导蛋白-10（IP-10）对结核菌素纯蛋白衍生物（QuantiFERON-TB Gold In tube，QFT-IT）抗原的反应与结核病（TB）有关。然而，其对活动性 TB 的特异性低于 QFT-IT 报道的特异性，这使得 TB 检测的准确性受到质疑。为了调查这种不确定性，可能是由于印度是结核病的高度流行地区，为了更好地确定 TB 相关因素，我们在意大利（结核病低度流行地区）的 HIV 感染患者中评估了基于 IP-10 的检测。
方法
前瞻性纳入 195 例患者；118 例为 HIV 感染者（21 例活动性 TB，97 例无活动性 TB，并分为高/低 TB 风险）。进行 QFT-IT，并通过 ELISA 评估 IP-10。
结果
在 HIV 感染者中，基于 IP-10 的检测对活动性 TB 的敏感性为 66.7%，而 QFT-IT 为 52.4%（p = 1）。基于 IP-10 的检测对刺激物反应和 CD4 计数的依赖性低于 QFT-IT。在无活动性 TB 的患者中，高 TB 风险患者的 IP-10 反应者比例高于低 TB 风险患者（40.0%比 12.9%），与 QFT-IT 相似（37.1%比 4.8%）。基于 IP-10 的检测对低 TB 风险患者的活动性 TB 的特异性为 87.1%，而 QFT-IT 为 95.2%。
结论
在结核病低度流行地区，除 IFN-γ 外，IP-10 对 QFT-IT 的反应与 HIV 感染者的活动性 TB 和 TB 危险因素相关，对刺激物反应和 CD4 计数的依赖性较低。
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