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Title: ESAT-6 and CFP-10 can be Combined to Reduce the Cost of Testing for Mycobacterium Tuberculosis Infection, but CFP-10 Responses Associate with Active Disease
Authors: Fox, Annette
Jeffries, David J.
Hill, Philip C.
Hammond, Abdulrahman S.
Lugos, Moses D.
Jackson-Sillah, Dolly
Donkor, Simon A.
Owiafe, Patrick K.
McAdam, Keith P.W.J.
Brookes, Roger H.
Issue Date: 2007
Publisher: Transactions of the Royal Society of Tropical Medicine and Hygiene
Series/Report no.: Vol. 101;Pp 691—698
Abstract: Commercial tests measuring IFN- responses to ESAT-6 and CFP-10 are available for diagnosing Mycobacterium tuberculosis infection. Measures that minimize cost and complexity will facilitate their application in less-developed countries. We investigated whether overlapping peptides representing both ESAT-6 and CFP-10 are required to detect M. tuberculosis infection in a high TB-burden country, and whether they can be combined in a single pool. ESAT-6 and CFP-10 peptides were compared in IFN- enzyme-linked immunospot (ELISPOT) in 183 HIV-negative smear-positive TB cases and 1673 HIV-negative household contacts. Separate peptide pools for each antigen were compared with a combined pool in 498 contacts. Forty per cent of responsive contacts recognized both antigens, 51% only ESAT-6 and 10% only CFP-10, whereas 56% of responsive cases recognized both antigens, 30% only ESAT-6 and 13% only CFP-10. Accordingly, CFP-10 response rates were higher for TB cases (odds ratio 2.409, P < 0.001). Low purified protein derivative response rates indicated that responses to CFP-10 only were nonspecific in contacts. Agreement between peptides in separate versus combined pools was good ( = 0.758, r = 0.840). Therefore a combined ESAT-6/CFP-10 peptide pool provided maximum sensitivity and efficiency, but CFP-10 was mainly required to detect active disease. © 2007 Royal Society of Tropical Medicine and Hygiene. Published by Elsevier Ltd. All rights reserved.
URI: http://hdl.handle.net/123456789/1694
Appears in Collections:Medical Laboratory Sciences

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