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Home >> Publications >> Detection of tuberculosis in HIV-infected children using an enzyme-linked immunospot assay.

Publication

Author(s):

Davies MA, Connell T, Johannisen C, Wood K, Pienaar S, Wilkinson KA, Wilkinson RJ, Zar HJ, Eley B, Beatty D, Curtis N, Nicol MP.

Pub Title:

Detection of tuberculosis in HIV-infected children using an enzyme-linked immunospot assay.

Pub Date:

May 15 2009

Pub Region(s):

Southern Africa

Journal Issue:

8

Page Number:
961-9

Journal:

Title: 
AIDS
Link: 
http://journals.lww.com/aidsonline/pages/articleviewer.aspx?year=2009&issue=05150&article=00011&type=abstract

PubMed: 19287300
Pub PDF: PDF icon 19287300.pdf

Abstract
OBJECTIVE
: To evaluate an enzyme-linked immunospot assay (ELISPOT) for the diagnosis of tuberculosis (TB) in HIV-infected children with suspected TB and to compare the performance of ELISPOT with the tuberculin skin test (TST).

METHODS: Interferon-gamma responses to Mycobacterium tuberculosis-specific antigens were measured by ELISPOT in HIV-infected children with suspected TB. HIV-infected and HIV-uninfected children without TB were taken for comparison.

RESULTS: Results were available for 188 children, of whom 139 (74%) were HIV-infected. Of these, 22 were classified as having definite TB: 24 probable TB, 14 possible TB and 128 not having TB. The median (range) age of patients was 20 (10-54.1) months. Median interferon-gamma responses to early-secreted antigenic target-6 and culture filtrate protein-10 were higher in children with definite or probable TB compared with children without TB (P < 0.002). In HIV-infected children with an interpretable ELISPOT result, the ELISPOT was positive in 14/21 (66%) with definite TB. A significantly higher proportion of HIV-infected children with definite or probable TB had a positive ELISPOT compared with a positive TST [25/39 (64%) vs. 10/34 (29%), P = 0.005]. In contrast to TST, results from ELISPOT were not affected by young age or severe immunosuppression. In HIV-infected children without active TB disease, 27% had a positive ELISPOT, suggesting latent TB infection.

CONCLUSION: ELISPOT is more sensitive than TST for the detection of active TB in HIV-infected children. However, the sensitivity of current ELISPOT assays is not sufficiently high to be used as a rule out test for TB.

PMID: 19287300 [PubMed - indexed for MEDLINE]

 

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Citation:

Davies MA, Connell T, Johannisen C, Wood K, Pienaar S, Wilkinson KA, Wilkinson RJ, Zar HJ, Eley B, Beatty D, Curtis N, Nicol MP. Detection of tuberculosis in HIV-infected children using an enzyme-linked immunospot assay. AIDS. 2009 May 15;23(8):961-9. doi: 10.1097/QAD.0b013e32832956ad. PubMed PMID: 19287300.