Evaluation of IP-10 in IGRA for LTBI diagnosis
L. Petrone (Rome, Italy), E. Petruccioli (Rome, Italy), V. Vanini (Rome, Italy), T. Chiacchio (Rome, Italy), G. Cuzzi (Rome, Italy), F. Palmieri (Rome, Italy), G. Ippolito (Rome, Italy), D. Goletti (Rome, Italy)
Source: International Congress 2018 – Tuberculosis transmission and screening strategies
Session: Tuberculosis transmission and screening strategies
Session type: Poster Discussion
Number: 5271
Disease area: Respiratory infections
Abstract Introduction: The QuantiFERON-TB Gold Plus (QFT-P) is a new Interferon Gamma Release Assay (IGRA) for latent tuberculosis infection (LTBI) diagnosis, in which a new tube containing shorter peptides stimulating CD8 T-cells, in addition to those stimulating CD4, has been added. Evaluation of alternative biomarkers to Interferon-? (IFN-?) in QFT-P may improve its sensitivity. Among several factors, Interferon-? inducible protein 10 (IP-10), has been proposed as a tuberculosis (TB) biomarker.
Aims and objectives: To evaluate the IP-10 accuracy for LTBI diagnosis, as an alternative marker for QFT-P.
Methods: We enrolled 36 active TB, 31 LTBI and 16 healthy donors (HD). QFT-P was performed and IP-10 detected by ELISA.
Results: IP-10 in response to both TB1 and TB2 antigens is increased in subjects with Active TB and LTBI compared to HD. A ROC analysis comparing Active TB and HD showed significant area under curve (AUC) results (AUC, 0.95 and 0.93 respectively; p<0.0001). A cut-off of >1174 pg/mL for TB1 and 928.8 pg/mL for TB2 identified Active TB with 86% sensitivity (Se) and 94% specificity (Sp), as previously shown measuring IFN-?. The numbers of responders based on IP-10 is higher compared to QFT-P (31 vs 30). Moreover, increased IP-10 in response to TB1 is found in subjects with LTBI compared to those with Active TB. A ROC analysis showed significant AUC results (AUC, 0.68; p=0.01) and a cut-off point of =16108 pg/mL was chosen to maximize the test performance. However, the test predicted LTBI only with 61% Se and 58% Sp.
Conclusions: These results suggest that IP-10 is an alternative biomarker to IFN-? in the QFT-Plus format; However, as previously demonstrated for IFN-? response, it cannot discriminate LTBI from active TB.
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L. Petrone (Rome, Italy), E. Petruccioli (Rome, Italy), V. Vanini (Rome, Italy), T. Chiacchio (Rome, Italy), G. Cuzzi (Rome, Italy), F. Palmieri (Rome, Italy), G. Ippolito (Rome, Italy), D. Goletti (Rome, Italy). Evaluation of IP-10 in IGRA for LTBI diagnosis. 5271
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