Darougar Sepideh, Moniri Afshin, Baghaei Parvaneh, Mortaz Esmaeil, Sadr Makan, Moniri Arad, Marjani Majid, Tabarsi Payam
Department of Pediatrics, Faculty of Medicine, Tehran Medical Sciences, Islamic Azad University, Tehran, Iran.
Virology Research Center, National Research Institute of Tuberculosis and Lung Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Int J Mycobacteriol. 2024 Oct 1;13(4):404-409. doi: 10.4103/ijmy.ijmy_194_24. Epub 2024 Dec 19.
Tuberculosis (TB) poses a significant public health challenge, particularly because it can exist in an asymptomatic latent phase. Latent TB infection indicates the presence of Mycobacterium tuberculosis without clinical symptoms. Effectively distinguishing between active and latent TB is essential, especially in regions with high TB prevalence, as it may help reduce transmission rates. This study aims to evaluate C1q as a potential biomarker for differentiating active TB from latent forms.
This prospective cross-sectional study was conducted from January 2017 to February 2018, involving HIV-negative adults aged 18 and older attending TB clinics. Participants were categorized based on clinical symptoms, imaging results, and laboratory tests into active or latent TB. Blood samples were collected to assess serum C1q levels, which were then compared between the two groups.
Out of 81 patients referred for TB evaluation, 38 were diagnosed with active TB. The overall median C1q level was 6.46 μg/ml (interquartile range 4.66-10). The active TB group exhibited significantly elevated C1q levels (10.21 μg/ml) compared to the latent TB group (6.03 μg/ml, P < 0.001). The area under the receiver operating characteristic curve for C1q in distinguishing active from latent TB was 0.74 (95% confidence interval, 0.63-0.85), with sensitivity varying between 61% and 82% at different threshold values.
C1q shows potential as a reliable and easily obtainable biomarker for differentiating active TB from latent infection, demonstrating high sensitivity. These results underscore the need for further research to explore the clinical application of C1q in TB diagnostics.
结核病对公共卫生构成重大挑战，特别是因为它可以处于无症状的潜伏期。潜伏性结核感染表明存在结核分枝杆菌但无临床症状。有效区分活动性结核和潜伏性结核至关重要，尤其是在结核病高流行地区，因为这可能有助于降低传播率。本研究旨在评估C1q作为区分活动性结核与潜伏性结核的潜在生物标志物。
这项前瞻性横断面研究于2017年1月至2018年2月进行，纳入了就诊于结核病诊所的18岁及以上HIV阴性成年人。参与者根据临床症状、影像学结果和实验室检查分为活动性或潜伏性结核。采集血样以评估血清C1q水平，然后在两组之间进行比较。
在81名接受结核病评估的患者中，38例被诊断为活动性结核。C1q的总体中位数水平为6.46μg/ml（四分位间距4.66 - 10）。与潜伏性结核组（6.03μg/ml）相比，活动性结核组的C1q水平显著升高（10.21μg/ml，P < 0.001）。C1q区分活动性结核与潜伏性结核的受试者工作特征曲线下面积为0.74（95%置信区间，0.63 - 0.85），在不同阈值下敏感性在61%至82%之间变化。
C1q显示出作为区分活动性结核与潜伏性感染的可靠且易于获得的生物标志物的潜力，具有高敏感性。这些结果强调需要进一步研究以探索C1q在结核病诊断中的临床应用。
