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|Title: ||Decay Kinetics of an Interferon Gamma Release Assay with Anti-Tuberculosis Therapy in Newly Diagnosed Tuberculosis Cases|
|Authors: ||Adetifa, Ifedayo M. O.|
Ota, Martin O. C.
Hammond, Abdulrahman S.
Lugos, Moses D.
Jeffries, David J.
Donkor, Simon A.
Adegbola, Richard A.
Hill, Philip C.
|Issue Date: ||2010|
|Publisher: ||PLoS ONE|
|Citation: ||Adetifa IMO, Ota MOC, Walther B, Hammond AS, Lugos MD, et al. (2010) Decay Kinetics of an Interferon Gamma Release Assay with Anti-Tuberculosis Therapy in Newly Diagnosed Tuberculosis Cases. PLoS ONE 5(9): e12502. doi:10.1371/journal.pone.0012502|
|Series/Report no.: ||Vol. 5;Iss. 9 Pp 1 - 8|
|Abstract: ||Background: Qualitative and quantitative changes in IGRA response offer promise as biomarkers to monitor Tuberculosis
(TB) drug therapy, and for the comparison of new interventions. We studied the decay kinetics of TB-specific antigen T-cell
responses measured with an in-house ELISPOT assay during the course of therapy.
Methods: Newly diagnosed sputum smear positive TB cases with typical TB chest radiographs were recruited. All patients
were given standard anti-TB treatment. Each subject was followed up for 6 months and treatment outcomes were
documented. Blood samples were obtained for the ESAT-6 and CFP-10 (EC) ELISPOT at diagnosis, 1-, 2-, 4- and 6-months.
Qualitative and quantitative reversion of the ELISPOT results were assessed with McNemar test, conditional logistic
regression and mixed-effects hierarchical Poisson models.
Results: A total of 116 cases were recruited and EC ELISPOT was positive for 87% (95 of 109) at recruitment. There was a
significant decrease in the proportion of EC ELISPOT positive cases over the treatment period (p,0.001). Most of the
reversion occurred between the start and first month of treatment and at completion at 6 months. ESAT-6 had higher
median counts compared to CFP-10 at all time points. Counts for each antigen declined significantly with therapy
(p,0.001). Reverters had lower median SFUs at the start of treatment compared to non-Reverters for both antigens. Apart
from the higher median counts for non-Reverters, no other risk factors for non-reversion were found.
Conclusions: TB treatment induces qualitative and quantitative reversion of a positive in-house IGRA in newly diagnosed
cases of active TB disease. As this does not occur reliably in the majority of cured individuals, qualitative and quantitative
reversion of an IGRA ELISPOT has limited clinical utility as a surrogate marker of treatment efficacy.|
|Appears in Collections:||Medical Laboratory Sciences|
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