A multicentre evaluation of the accuracy and performance of IP-10 for the diagnosis of infection with M. tuberculosis

Ruhwald, Morten, Dominguez, Jose, Latorre, Irene, Losi, Monica, Richeldi, Luca, Pasticci, Maria Bruna, Mazzolla, Rosanna, Goletti, Delia, Butera, Ornella, Bruchfeld, Judith, Gaines, Hans, Gerogianni, Irini, Tuuminen, Tamara, Ferrara, Giovanni, Eugen-Olsen, Jesper and Ravn, Pernille (2011) A multicentre evaluation of the accuracy and performance of IP-10 for the diagnosis of infection with M. tuberculosis. Tuberculosis, 91 (3), 260-267. (doi:10.1016/j.tube.2011.01.001). (PMID:21459676)

Abstract

IP-10 has potential as a diagnostic marker for infection with Mycobacterium tuberculosis, with comparable accuracy to QuantiFERON-TB Gold In-Tube test (QFT-IT). The aims were to assess the sensitivity and specificity of IP-10, and to evaluate the impact of co-morbidity on IP-10 and QFT-IT. 168 cases with active TB, 101 healthy controls and 175 non-TB patients were included. IP-10 and IFN-? were measured in plasma of QFT-IT stimulated whole blood and analyzed using previously determined algorithms. A subgroup of 48 patients and 70 healthy controls was tested in parallel with T-SPOT.TB IP-10 and QFT-IT had comparable accuracy. Sensitivity was 81% and 84% with a specificity of 97% and 100%, respectively. Combining IP-10 and QFT-IT improved sensitivity to 87% (p < 0.0005), with a specificity of 97%. T-SPOT.TB was more sensitive than QFT-IT, but not IP-10. Among non-TB patients IP-10 had a higher rate of positive responders (35% vs 27%, p < 0.02) and for both tests a positive response was associated with relevant risk factors. IFN-? but not IP-10 responses to mitogen stimulation were reduced in patients with TB and non-TB infection. This study confirms and validates previous findings and adds substance to IP-10 as a novel diagnostic marker for infection with M. tuberculosis. IP-10 appeared less influenced by infections other than TB; further studies are needed to test the clinical impact of these findings.

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