Serial testing of latent tuberculosis infection in patients with diabetes mellitus using interferon-gamma release assay, tuberculin skin test, and creation tuberculin skin test

He, Yijun; Cao, Xuefang; Guo, Tonglei; He, Yongpeng; Du, Ying; Zhang, Haoran; Feng, Boxuan; Du, Jiang; Zhang, Bin; Wang, Kun; Yan, Jiaoxia; Wang, Dakuan; Liu, Zisen; Pan, Shouguo; Xin, Henan; Gao, Lei

doi:10.3389/fpubh.2022.1025550

Cited by 3 publications

(1 citation statement)

References 26 publications

(33 reference statements)

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“…The most significant limitations are that there may be false-positive results due to exposure to Mycobacterium other than tuberculosis (TB), such as Mycobacterium Bovis. TST also can come out positive because of BCG vaccination (Pai et al, 2014;He et al, 2022).…”

Section: Discussionmentioning

confidence: 99%

The Adjusted Cut-Off Value of Interferon-Γ Release Assays (IGRA) to Diagnose LTBI in Indonesia

Florencia Leona

2023

INSOLOGI: Jurnal Sains dan Teknologi

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Latent Tuberculosis Infection (LTBI) is as a condition when Mycobacterium tuberculosis (MTB) persists in the body without causing symptoms while maintaining viability with the possibility to become active tuberculosis in the future. The detection of LTBI is an important strategy from WHO to end the chain of tuberculosis. LTBI can be diagnosed by using the IGRA test. IGRA uses specific antigens of MTB, early antigenic target-6 (ESAT-6), to induce interferon-gamma production by antigen-specific T cells. In the IGRA test, the cut-off value is explicitly needed to distinguish healthy people from LTBI patients. This study aimed to find IGRA's adjusted cut-off value in Indonesia. The subjects were 150 people, which were 50 healthy people, 50 subjects with active TB, and 50 with suspected LTBI. Isolated Lymphocytes derived from PBMC sand were cultured in a complete RPMI medium and induced by Esat-6 for six days. IFN-g levels were assayed from supernatants by the sandwich Elisa technique. Statistical analysis was used to determine cut-off values for IFN-g derived from healthy and diseased patients. The highest aptitude index (κ value) that could discriminate between healthy and LTBI groups was 0.925 at a concentration of 0.792 ng/ml of IFN-g, hence the cut-off value to diagnose LTBI was 0.792 ng/ml of IFN-g. Based on this value, out of 40 suspected cases of LTBI, up to 17 (42.5%) and 23 without LTBI (57.5%) were found. So, the conclusion was that the adjusted cut-off value for IFN-g to diagnose LTBI in Indonesia was 0.792 ng/ml.

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Section: Discussionmentioning

confidence: 99%

The Adjusted Cut-Off Value of Interferon-Γ Release Assays (IGRA) to Diagnose LTBI in Indonesia

Florencia Leona

2023

INSOLOGI: Jurnal Sains dan Teknologi

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Impact of diabetes mellitus on tuberculosis prevention, diagnosis, and treatment from an immunologic perspective

Ye,

Li,

Yang

et al. 2024

Exploration

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The coexistence of diabetes mellitus (DM) and tuberculosis (TB) presents a significant global burden, with DM being recognized as a major risk factor for TB. This review comprehensively analyzes the immunological aspects of DM‐TB comorbidity, shedding light on the impact of DM on TB pathogenesis and immune responses. It reveals that high blood glucose levels in TB patients contribute to reduced innate immune cell count, compromised phagocytic function, and delayed antigen presentation. These factors ultimately impair the clearance of Mycobacterium tuberculosis (MTB) and delay adaptive immune responses. With the interaction between TB and DM, there is an increase in inflammation and elevated secretion of pro‐inflammatory cytokines by immune cells. This exacerbates the inflammatory response and contributes to poor treatment outcomes in TB. Moreover, the review explores the effects of DM on TB prevention, diagnosis, and treatment. It highlights how poor glycemic control, insulin resistance (IR), DM complications, and genetic factors increase the risk of MTB infection in individuals with DM. Additionally, DM‐related immune suppression adversely affects the sensitivity of traditional diagnostic tests for TB, potentially resulting in underdiagnosis and delayed intervention. To mitigate the burden of TB in DM patients, the review emphasizes the need for further research on the mechanisms underlying DM reactivation in latent TB infection (LTBI). It shows how important it is to find and treat LTBI in DM patients as soon as possible and suggests looking into biomarkers that are specific to DM to make diagnosis more accurate.

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Latent tuberculosis infection and diagnostic performance of the tuberculin skin test among type 2 diabetics in Sana’a city, Yemen

Abdul-Ghani,

Al-Awadi,

Al-aghbari

et al. 2024

BMC Infect Dis

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Background Tuberculosis (TB) is one of the most widespread infectious diseases worldwide, typically persisting in the body as a latent TB infection (LTBI). Patients with type 2 diabetes have an increased risk of LTBI progressing to active TB. Therefore, this study determined the prevalence and predictors of LTBI and assessed the agreement between tuberculin skin test (TST) and interferon-gamma release assay (IGRA) in diagnosing LTBI among type 2 diabetics in Sana’a city, Yemen. Methods A cross-sectional study was conducted among 150 type 2 diabetics in private health facilities in Sana’a in 2023. Data about demographics, diabetes-related characteristics, and potential risk factors for LTBI were collected using a structured questionnaire. Patients were then screened for LTBI using TST and IGRA. Univariate analysis was used to identify LTBI-associated risk factors, and multivariable binary logistic regression was used to identify independent predictors of LTBI. The agreement between TST and IGRA for diagnosing LTBI was assessed using Cohen’s kappa coefficient (κ). Results LTBI was prevalent among 29.3% of type 2 diabetics using both types of tests (25.3% with IGRA and 21.3% with TST). Male gender was an independent predictor of LTBI (AOR = 4.4, 95% confidence interval: 1.30–15.08; P = 0.018). However, being employed (AOR = 0.3, 95% CI: 0.09–0.75; P = 0.013) and longer duration since diabetes diagnosis (AOR = 0.3, 95% CI: 0.12–0.98; P = 0.046) were identified as predictors of lower LTBI risk. The agreement between TST and IGRA for the diagnosis of LTBI was 88%, with a good and statistically significant agreement between the two test types (κ = 0.670; P < 0.001). Conclusions LTBI is common among type 2 diabetics seeking medical care in Sana’a city, with about one-third of them possibly being latently infected. A higher LTBI risk can be predicted among males, while a lower risk can be predicted among those employed or being diagnosed with diabetes for at least five years. The TST shows good agreement with IGRA in diagnosing LTBI among type 2 diabetics, supporting its continued use as a cost-effective and easily accessible test for diagnosing LTBI in the country. Supplementary Information The online version contains supplementary material available at 10.1186/s12879-024-09931-8.

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Serial testing of latent tuberculosis infection in patients with diabetes mellitus using interferon-gamma release assay, tuberculin skin test, and creation tuberculin skin test

Cited by 3 publications

References 26 publications

The Adjusted Cut-Off Value of Interferon-Γ Release Assays (IGRA) to Diagnose LTBI in Indonesia

The Adjusted Cut-Off Value of Interferon-Γ Release Assays (IGRA) to Diagnose LTBI in Indonesia

Impact of diabetes mellitus on tuberculosis prevention, diagnosis, and treatment from an immunologic perspective

Latent tuberculosis infection and diagnostic performance of the tuberculin skin test among type 2 diabetics in Sana’a city, Yemen

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