Serological Diagnostic Assays for HIV-Associated Tuberculosis in Sub-Saharan Africa?

Lawn, Stephen D.

doi:10.1128/cvi.00201-14

Cited by 5 publications

(2 citation statements)

References 31 publications

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“…95,96 HIV-TB presents particular challenges for serological assays, for example the heterogeneity of immunological responses to MTB. 97,98 A recent case-control study examined antibody responses to several MTB proteins in HIV-TB and demonstrated moderate sensitivity. 99 Serological positivity was also common in HIV-infected controls, but the cross-sectional design was unable to differentiate poor specificity from early, subclinical disease that may have progressed to active TB.…”

Section: Other Future Diagnostic Technologiesmentioning

confidence: 99%

Advances in the Diagnosis of HIV-Associated Tuberculosis

Gupta-Wright¹,

2015

EMJ Respir

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HIV-associated tuberculosis (HIV-TB) remains a global public health challenge, with the major burden being borne by countries in low-resource settings. If World Health Organization targets to reduce TB deaths by 95% and new cases by 90% are to be met by 2035, major improvements in diagnostic strategies are among the most pressing needs. HIV coinfection presents particular challenges in the diagnosis of TB due, for example, to the relatively low mycobacterial burden in sputum specimens and rapid dissemination beyond the lungs. Low and middle-income countries still typically rely on traditional diagnostics such as chest radiology and sputum microscopy, which lack sufficient accuracy. Desired characteristics for an HIV-TB diagnostic test are well described and include the ability to test a wide variety of clinical samples, diagnose extra-pulmonary TB, have good accuracy to detect low mycobacterial burden disease, and be deployable at the peripheries of healthcare systems. Following a long period of under-investment in TB research, development of TB diagnostics has progressed rapidly over the past decade and the technology landscape looks much more promising. This article will summarise advances in diagnostics that are particularly relevant to HIV-TB. The Xpert® MTB/RIF and Determine™ TB LAM assays have the most evidence assessing their use in HIV-TB. In addition to nucleic-acid amplification tests and antigen detection we will review new diagnostic technologies. Finally, we discuss whether use of empirical TB treatment offsets the potential impact and reduces the need for new diagnostics.

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Section: Other Future Diagnostic Technologiesmentioning

confidence: 99%

Advances in the Diagnosis of HIV-Associated Tuberculosis

Gupta-Wright¹,

2015

EMJ Respir

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“…Following its commercial launch in 2013, Determine TB-LAM remains the focus of ongoing clinical evaluation studies. This is a simple, low-cost, POC assay which provides a qualitative (yes/no) readout of TB diagnosis within 30 min ( Lawn, 2014 ). While diagnostic evaluation of this kit showed a poor performance with unselected TB patients, combination of LAM lateral flow test with sputum microscopy demonstrated a diagnostic value in HIV immunocompromised TB patients (CD4 lymphocyte cell counts <50/μL; Lawn et al, 2012 ; Peter et al, 2012 ).…”

Section: Diagnostic Performance and Commercial Developmentmentioning

confidence: 99%

Pathogen-derived biomarkers for active tuberculosis diagnosis

2014

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Tuberculosis (TB) is an infectious disease caused by members of Mycobacterium tuberculosis complex. Despite the availability of effective treatments, TB remains a major public health concern in most low and middle-income countries, representing worldwide the second leading cause of death from an infectious disease. Inadequate case detection and failures to classify the disease status hamper proper TB control. The limitations of the conventional diagnostic methods have encouraged much research activities in this field, but there is still an urgent need for an accurate point of care test for active TB diagnosis. A rapid, precise, and inexpensive TB diagnostic test would allow an earlier implementation of an appropriate treatment and the reduction of disease transmission. Pathogen-derived molecules present in clinical specimens of affected patients are being validated for that purpose. This short review aims to summarize the available data regarding biomarkers derived from M. tuberculosis, and their current usage in active TB diagnosis.

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Identification of Antibody Targets for Tuberculosis Serology using High-Density Nucleic Acid Programmable Protein Arrays

Song

Wallstrom

et al. 2017

Molecular & Cellular Proteomics

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Better and more diverse biomarkers for the development of simple point-of-care tests for active tuberculosis (TB), a clinically heterogeneous disease, are urgently needed. We generated a proteomic Mycobacterium tuberculosis (Mtb) High-Density Nucleic Acid Programmable Protein Array (HD-NAPPA) that used a novel multiplexed strategy for expedited high-throughput screening for antibody responses to the Mtb proteome. We screened sera from HIV uninfected and coinfected TB patients and controls (n ‫؍‬ 120) from the US and South Africa (SA) using the multiplex HD-NAPPA for discovery, followed by deconvolution and validation through single protein HD-NAPPA with biologically independent samples (n ‫؍‬ 124). We verified the top proteins with enzyme-linked immunosorbent assays (ELISA) using the original screening and validation samples (n ‫؍‬ 244) and heretofore untested samples (n ‫؍‬ 41). We identified 8 proteins with TB biomarker value; four (Rv0054, Rv0831c, Rv2031c and Rv0222) of these were previously identified in serology studies, and four (Rv0948c, Rv2853, Rv3405c, Rv3544c) were not known to elicit antibody responses. Using ELISA data, we created classifiers that could discriminate patients' TB status according to geography (

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Serological Diagnostic Assays for HIV-Associated Tuberculosis in Sub-Saharan Africa?

Abstract: In this issue of

Cited by 5 publications

References 31 publications

Advances in the Diagnosis of HIV-Associated Tuberculosis

Advances in the Diagnosis of HIV-Associated Tuberculosis

Pathogen-derived biomarkers for active tuberculosis diagnosis

Identification of Antibody Targets for Tuberculosis Serology using High-Density Nucleic Acid Programmable Protein Arrays

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