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  • PMID: 26945178 was deleted because it is a duplicate of PMID: 27306506
J Acquir Immune Defic Syndr. 2016 Jul 1;72(3):344-52. doi: 10.1097/QAI.0000000000000980.

Added Value of Long-Term Cytokine Release Assays to Detect Mycobacterium tuberculosis Infection in HIV-Infected Subjects in Uganda.

Author information

1
*Laboratory of Vaccinology and Mucosal Immunity, Université Libre de Bruxelles (ULB), Brussels, Belgium; †Currently, CHU Pointe-à-Pitre, Pointe-à-Pitre, Guadeloupe; ‡Laboratory of Immunology, Department of Biomedical Sciences, Institute of Tropical Medicine, Antwerp, Belgium; §Currently, Centre de Recherches Médicales de Lambaréné (CERMEL), Lambaréné, Gabon; ‖Département de Bacterio-virologie, Université des Sciences de la Santé, Libreville, Gabon; ¶Institut für Tropenmedizin, Universität Tübingen, Tübingen, Germany; #Department of Medicine, Mulago Hospital, College of Health Sciences, Makarere University, Kampala, Uganda; **Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium; ††Epidemiology and Social Medicine, University of Antwerp, Antwerp, Belgium; ‡‡Currently, International Health Unit, Faculty of Medicine and Health Sciences, Gouverneur Kinsbergen Centrum, University of Antwerp, Wilkrijk, Belgium; §§Lionex Diagnostics & Therapeutics, Braunschweig, Germany; ‖‖Inserm, U1019, Lille, France; ¶¶CNRS, UMR8204, Lille, France; ##University of Lille, U1019-UMR8204-CIIL-, Center for Infection and Immunity of Lille, Lille, France; ***Institut Pasteur de Lille, Lille, France; †††Department of Biomedical Sciences, University of Antwerp, Antwerp, Belgium; and ‡‡‡Immunobiology Clinic, Hôpital Erasme, Université Libre de Bruxelles (ULB), Brussels, Belgium.

Abstract

OBJECTIVES:

To investigate whether mycobacterial antigen-induced cytokine secretions are helpful in detecting Mycobacterium tuberculosis (Mtb) infection in a cohort of HIV-infected patients living in a country with a high burden of Mtb and HIV infections, and to determine their predictive value for the development of tuberculosis (TB)-associated immune reconstitution inflammatory syndrome.

DESIGN:

A total of 352 HIV-infected patients (186 with active TB) were prospectively enrolled when initiating antiretroviral therapy (ART). Sequential blood samples were collected during the first 6 months of ART. Eighty-three HIV-uninfected subjects (39 with active TB) were enrolled as controls.

METHODS:

The concentrations of 13 cytokines were measured in supernatants from blood mononuclear cells in vitro stimulated with purified protein derivative (PPD), heparin-binding hemagglutinin (HBHA) or early secreted antigen-6 (ESAT-6) and culture filtrate protein-10 (CFP-10), and results were compared with those of tuberculin skin tests (TST).

RESULTS:

The best detection of Mtb infection was achieved by ESAT-6/CFP-10-induced interferon-γ concentrations, but results were often negative for patients with CD4 T-cell counts <50 per cubic millimeters. Patients with active TB were identified by high ESAT-6/CFP-10-induced interleukin-6. Conversions of interferon-γ-release assays (IGRA) and TST occurred under ART, and combined TB and antiretroviral treatments of coinfected patients resulted in a decrease of ESAT-6/CFP-10-induced and an increase of HBHA-induced interferon-γ responses. No Mtb antigen-induced cytokines allowed us to predict TB-immune reconstitution inflammatory syndrome or ART-associated TB.

CONCLUSIONS:

In Uganda, ESAT-6/CFP-10-IGRA is better in detecting Mtb infection than TST and, when combined with an HBHA-IGRA, could help to evaluate anti-TB treatment success.

PMID:
27306506
PMCID:
PMC4915752
DOI:
10.1097/QAI.0000000000000980
[Indexed for MEDLINE]

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