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Clin Microbiol Infect. 2016 Dec;22(12):1007.e1-1007.e5. doi: 10.1016/j.cmi.2016.09.004. Epub 2016 Sep 16.

Detection of interleukin-2 is not useful for distinguishing between latent and active tuberculosis in clinical practice: a prospective cohort study.

Author information

1
Service of Infectious Diseases, Bellvitge University Hospital-IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain; Department of Clinical Sciences, University of Barcelona, L'Hospitalet de Llobregat, Barcelona, Spain. Electronic address: msantin@bellvitgehospital.cat.
2
Service of Immunology, Bellvitge University Hospital-IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain.
3
Service of Microbiology, Bellvitge University Hospital-IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain; Department of Pathology and Experimental Therapy, University of Barcelona, L'Hospitalet de Llobregat, Barcelona, Spain.
4
Unit of Infectious Diseases, Hospital Universitario Lucus Augusti, Lugo, Spain.
5
Unit of Tuberculosis, Service of Infectious Diseases-Internal Medicine, Complexo Hospitalario Universitario de Pontevedra, Pontevedra, Spain.
6
Service of Respiratory Diseases, Hospital Universitario Marqués de Valdecilla, Santander, Spain.
7
Respiratory Diseases, Hospital General Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Barcelona.
8
Unidad de Gestión Clínica Enfermedades Infecciosas y Microbiología, Hospital de Jerez, Jerez de la Frontera, Cádiz, Spain.
9
Clinic Unit of Infectious Diseases and Preventive Medicine, Hospital Virgen Macarena, Sevilla, Spain.
10
Service of Infectious Diseases, Institut Mar d'Investigacions Mèdiques (IMIM), Hospital del Mar, Barcelona, Spain.
11
Service of Microbiology, Hospital Universitario Lucus Augusti, Lugo, Spain.
12
Service of Microbiology, Complexo Hospitalario Universitario de Pontevedra, Pontevedra, Spain.
13
Service of Microbiology, Hospital General Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Barcelona, Spain.
14
Service of Microbiology, Bellvitge University Hospital-IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain.
15
Unidad de Tuberculosis, Hospital Universitario Lucus Augusti, Lugo, Spain.
16
Service of Respiratory Diseases, Complexo Hospitalario Universitario de Pontevedra, Pontevedra, Spain.
17
Service of Internal Medicine, Complexo Hospitalario Universitario de Pontevedra, Pontevedra, Spain.
18
Service of Respiratory Diseases, Hospital de Barbastro, Huesca, Spain.
19
Service of Microbiology, Hospital Universitario Marqués de Valdecilla, Santander, Spain.
20
Service of Immunology, Hospital de Jerez, Jerez de la Frontera, Cádiz, Spain.

Abstract

OBJECTIVE:

Previous reports have identified interleukin-2 (IL-2), quantified in the supernatants of QuantiFERON®-TB Gold In-tube (QFT) after 72 h of incubation, as a potential biomarker for distinguishing between latent and active tuberculosis (TB). However, its validity has not been tested in an appropriate clinical cohort.

METHODS:

A multicentre study of 161 consecutive adult patients undergoing evaluation for active TB at eight TB Units in Spain. Interferon-γ (IFN-γ) and IL-2 were assessed in the supernatant of QFT after 16-24 h and 72 h of incubation. The accuracy of IL-2 for indicating latent TB infection (LTBI) was assessed by receiving operating characteristic curves. .

RESULTS:

Twenty-eight participants were not infected, 43 had LTBI, 69 had TB, and 21 were not classifiable. Median (interquartile range) IL-2 concentrations after 72 h of incubation were 0.0 pg/mL (0.0-0.0) in uninfected individuals, 261.0 pg/mL (81.0-853.0) in LTBI individuals, 166.5 pg/mL (33.5-551.5) in patients with extrapulmonary TB, 95.0 pg/mL (26.0-283.0) in patients with smear-negative pulmonary TB, and 38.5 pg/mL (7.5-178.0) in patients with smear-positive pulmonary TB (p <0.0001). The area under the curve of the receiving operating characteristic curve (95% CI) of IL-2 after 72 h of incubation for the diagnosis of LTBI was 0.63 (0.53-0.74) when all TB cases were considered as a single group, ranging from 0.59 (0.47-0.71) to 0.72 (0.58-0.85) when only extrapulmonary and smear-positive pulmonary TB cases respectively were considered.

CONCLUSIONS:

Quantification of IL-2 in the supernatant of QFT after a prolonged incubation is not useful to distinguish between LTBI and active disease in clinical practice.

KEYWORDS:

Active tuberculosis; Interferon-γ; Interleukin-2; Latent tuberculosis infection; QuantiFERON

PMID:
27647563
DOI:
10.1016/j.cmi.2016.09.004
[Indexed for MEDLINE]
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