Plasma profiles of inflammatory markers associated with active tuberculosis in antiretroviral therapy-naive human immunodeficiency virus-positive individuals
(2019) In Open Forum Infectious Diseases 6(2).- Abstract
Background. Diagnosis of tuberculosis (TB) in human immunodeficiency virus (HIV)-coinfected individuals is challenging. We hypothesized that combinations of inflammatory markers could facilitate identification of active TB in HIV-positive individuals. Methods. Participants were HIV-positive, treatment-naive adults systematically investigated for TB at Ethiopian health centers. Plasma samples from 130 subjects with TB (HIV+/TB+) and 130 subjects without TB (HIV+/TB−) were tested for concentration of the following markers: CCL5, C-reactive protein (CRP), interleukin (IL)-6, IL12-p70, IL-18, IL-27, interferon-γ-induced protein-10 (IP-10), procalcitonin (PCT), and soluble urokinase-type... (More)
Background. Diagnosis of tuberculosis (TB) in human immunodeficiency virus (HIV)-coinfected individuals is challenging. We hypothesized that combinations of inflammatory markers could facilitate identification of active TB in HIV-positive individuals. Methods. Participants were HIV-positive, treatment-naive adults systematically investigated for TB at Ethiopian health centers. Plasma samples from 130 subjects with TB (HIV+/TB+) and 130 subjects without TB (HIV+/TB−) were tested for concentration of the following markers: CCL5, C-reactive protein (CRP), interleukin (IL)-6, IL12-p70, IL-18, IL-27, interferon-γ-induced protein-10 (IP-10), procalcitonin (PCT), and soluble urokinase-type plasminogen activator receptor (suPAR). Analyzed markers were then assessed, either individually or in combination, with regard to infection status, CD4 cell count, and HIV ribonucleic acid (RNA) levels. Results. The HIV+/TB+ subjects had higher levels of all markers, except IL12p70, compared with HIV+/TB− subjects. The CRP showed the best performance for TB identification (median 27.9 vs 1.8 mg/L for HIV+/TB+ and HIV+/TB−, respectively; area under the curve [AUC]: 0.80). Performance was increased when CRP was combined with suPAR analysis (AUC, 0.83 [0.93 for subjects with CD4 cell count <200 cells/mm3]). Irrespective of TB status, IP-10 concentrations correlated with HIV RNA levels, and both IP-10 and IL-18 were inversely correlated to CD4 cell counts. Conclusions. Although CRP showed the best single marker discriminatory potential, combining CRP and suPAR analyses increased performance for TB identification.
(Less)
- author
- Olsson, Oskar LU ; Björkman, Per LU ; Jansson, Marianne LU ; Balcha, Taye Tolera LU ; Mulleta, Daba ; Yeba, Habtamu ; Valfridsson, Christine LU ; Carlsson, Fredric LU and Skogmar, Sten LU
- organization
-
- Clinical infection medicine (research group)
- Clinical Microbiology, Malmö (research group)
- HIV-1 and HIV-2 host interactions (research group)
- Division of Medical Microbiology
- Infectious Immunology (research group)
- Glucose Transport and Protein Trafficking (research group)
- Molecular Cell Biology
- Infectious Diseases Research Unit (research group)
- Microbiology Group (research group)
- publishing date
- 2019-02-01
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- Biomarker, CRP, HIV, Mycobacterium tuberculosis, Sub-Saharan Africa
- in
- Open Forum Infectious Diseases
- volume
- 6
- issue
- 2
- article number
- ofz015
- publisher
- Oxford University Press
- external identifiers
-
- scopus:85066460906
- pmid:30800697
- ISSN
- 2328-8957
- DOI
- 10.1093/ofid/ofz015
- language
- English
- LU publication?
- yes
- id
- aae8a5ed-f7bc-4c3c-aad1-e97ecb67c22b
- date added to LUP
- 2019-06-17 19:27:09
- date last changed
- 2024-09-05 00:11:44
@article{aae8a5ed-f7bc-4c3c-aad1-e97ecb67c22b, abstract = {{<p>Background. Diagnosis of tuberculosis (TB) in human immunodeficiency virus (HIV)-coinfected individuals is challenging. We hypothesized that combinations of inflammatory markers could facilitate identification of active TB in HIV-positive individuals. Methods. Participants were HIV-positive, treatment-naive adults systematically investigated for TB at Ethiopian health centers. Plasma samples from 130 subjects with TB (HIV<sup>+</sup>/TB<sup>+</sup>) and 130 subjects without TB (HIV<sup>+</sup>/TB<sup>−</sup>) were tested for concentration of the following markers: CCL5, C-reactive protein (CRP), interleukin (IL)-6, IL12-p70, IL-18, IL-27, interferon-γ-induced protein-10 (IP-10), procalcitonin (PCT), and soluble urokinase-type plasminogen activator receptor (suPAR). Analyzed markers were then assessed, either individually or in combination, with regard to infection status, CD4 cell count, and HIV ribonucleic acid (RNA) levels. Results. The HIV<sup>+</sup>/TB<sup>+</sup> subjects had higher levels of all markers, except IL12p70, compared with HIV<sup>+</sup>/TB<sup>−</sup> subjects. The CRP showed the best performance for TB identification (median 27.9 vs 1.8 mg/L for HIV<sup>+</sup>/TB<sup>+</sup> and HIV<sup>+</sup>/TB<sup>−</sup>, respectively; area under the curve [AUC]: 0.80). Performance was increased when CRP was combined with suPAR analysis (AUC, 0.83 [0.93 for subjects with CD4 cell count <200 cells/mm<sup>3</sup>]). Irrespective of TB status, IP-10 concentrations correlated with HIV RNA levels, and both IP-10 and IL-18 were inversely correlated to CD4 cell counts. Conclusions. Although CRP showed the best single marker discriminatory potential, combining CRP and suPAR analyses increased performance for TB identification.</p>}}, author = {{Olsson, Oskar and Björkman, Per and Jansson, Marianne and Balcha, Taye Tolera and Mulleta, Daba and Yeba, Habtamu and Valfridsson, Christine and Carlsson, Fredric and Skogmar, Sten}}, issn = {{2328-8957}}, keywords = {{Biomarker; CRP; HIV; Mycobacterium tuberculosis; Sub-Saharan Africa}}, language = {{eng}}, month = {{02}}, number = {{2}}, publisher = {{Oxford University Press}}, series = {{Open Forum Infectious Diseases}}, title = {{Plasma profiles of inflammatory markers associated with active tuberculosis in antiretroviral therapy-naive human immunodeficiency virus-positive individuals}}, url = {{http://dx.doi.org/10.1093/ofid/ofz015}}, doi = {{10.1093/ofid/ofz015}}, volume = {{6}}, year = {{2019}}, }