Serological markers predicting tuberculosis in human immunodeficiency virus-infected patients

Amicosante, M., Richeldi, L., Monno, L., Cuboni, A., Tartoni, P.L., Angarano, G., Orefici, G. and Saltini, C. (1997) Serological markers predicting tuberculosis in human immunodeficiency virus-infected patients. International Journal of Tuberculosis and Lung Disease, 1 (5), 435-440. (PMID:9441098)

Abstract

SETTING: Human immunodeficiency virus (HIV)-positive patients retrospectively identified at the Hospital of Bari, Italy, with diagnosis of tuberculosis (TB) (n = 30) or non-tuberculous pneumonia (n = 29). Serum samples drawn at the time of diagnosis and one year before. Anti-purified protein derivative (PPD) and anti-diacyltrehalose (DAT) serum antibodies quantified by ELISA assay.

OBJECTIVE: Since TB patients with HIV infection may present with elevated serum antibodies against Mycobacterium tuberculosis, we hypothesized that TB-specific antibody markers might predict TB in these subjects.

DESIGN: A retrospective study was designed to assess the presence of M. tuberculosis-specific antibodies in HIV-positive patients developing TB.

RESULTS: Of 30 HIV-positive TB patients, 24 (80%) had anti-PPD or anti-DAT antibodies at the time of TB diagnosis, and 20 (67%) one year before. In a sub-population of 16 of the 30 HIV-positive subjects, positivity for anti-PPD or anti-DAT antibodies one year before TB diagnosis was higher (11/16, 69%) than for the PPD skin test (4/16, 25%, P < 0.01). Antibody tests were specific for TB since positivity rates were lower both in patients with non-tuberculous pneumonia (P < 0.01) and in those with M. avium infection (P < 0.05).

CONCLUSION: Antibody markers may predict TB in HIV-positive subjects, including those with negative PPD skin test.

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