Diagnostic performance of blood inflammatory markers for tuberculosis screening in people living with HIV

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dc.contributor.authorFarr, Katherine
dc.contributor.authorRavindran, Resmi
dc.contributor.authorStrnad, Luke
dc.contributor.authorChang, Emily
dc.contributor.authorChaisson, Lelia H.
dc.contributor.authorYoon, Christina
dc.contributor.authorWorodria, William
dc.contributor.authorAndama, Alfred
dc.contributor.authorAyakaka, Irene
dc.contributor.authorBbosa Nalwanga, Priscilla
dc.contributor.authorByanyima, Patrick
dc.contributor.authorKalema, Nelson
dc.contributor.authorKaswabuli, Sylvia
dc.contributor.authorKatagira, Winceslaus
dc.contributor.authorDenise Aman, Kyomugisha
dc.contributor.authorMusisi, Emmanuel
dc.contributor.authorTumwine, Nuwagaba Wallen
dc.contributor.authorSanyu, Ingvar
dc.contributor.authorSsebunya, Robert
dc.contributor.authorDavis, J. Lucian
dc.contributor.authorHuang, Laurence
dc.contributor.authorKhan, Imran H.
dc.contributor.authorCattamanchi, Adithya
dc.date.accessioned2022-05-11T17:41:32Z
dc.date.available2022-05-11T17:41:32Z
dc.date.issued2018
dc.description.abstractApproaches to screening for active tuberculosis (TB) among people living with HIV are inadequate, leading to missed diagnoses and poor implementation of preventive therapy. Methods Consecutive HIV-infected adults hospitalized at Mulago Hospital (Kampala, Uganda) between June 2011 and July 2013 with a cough � 2 weeks were enrolled. Patients underwent extensive evaluation for pulmonary TB. Concentrations of 43 cytokines/chemokines were measured at the same time point as C-reactive protein (CRP) in banked plasma samples using commercially-available multiplex kits. Advanced classification algorithms were used to rank cytokines/chemokines for their ability to identify TB, and to model the specificity of the top-ranked cytokines/chemokines individually and in combination with sensitivity constrained to � 90% as recommended for TB screening. Results The median plasma level of 5 biomarkers (IL-6, INF-γ, MIG, CRP, IL-18) was significantly different between patients with and without TB. With sensitivity constrained to 90%, all had low specificity with IL-6 showing the highest specificity (44%; 95% CI 37.4–49.5). Biomarker panels were found to be more valuable than any biomarker alone. A panel combining IFN-γ and IL-6 had the highest specificity (50%; 95% CI 46.7–53.3). Sensitivity remained high (>85%) for all panels among sputum smear-negative TB patients. Conclusions Direct measurement of unstimulated plasma cytokines/chemokines in peripheral blood is a promising approach to TB screening. Cytokine/chemokine panels retained high sensitivity for smear-negative TB and achieved improved specificity compared to individual cytokines/ chemokines. These markers should be further evaluated in outpatient settings where most TB screening occurs and where other illnesses associated with systematic inflammation are less common.en_US
dc.identifier.citationFarr K, Ravindran R, Strnad L, Chang E, Chaisson LH, Yoon C, et al. (2018) Diagnostic performance of blood inflammatory markers for tuberculosis screening in people living with HIV. PLoS ONE 13(10): e0206119. https://doi.org/ 10.1371/journal.pone.0206119en_US
dc.identifier.urihttps://doi.org/ 10.1371/journal.pone.0206119
dc.identifier.urihttps://nru.uncst.go.ug/handle/123456789/3223
dc.language.isoenen_US
dc.publisherPLoS ONEen_US
dc.subjectBlood inflammatory markersen_US
dc.subjectTuberculosis screeningen_US
dc.subjectHIVen_US
dc.titleDiagnostic performance of blood inflammatory markers for tuberculosis screening in people living with HIVen_US
dc.typeArticleen_US
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