OPPORTUNITIES OF IMMUNODIAGNOSTICS OF TUBERCULOSIS IN THE PATIENTS AT ADVANCED STAGES OF HIV INFECTION
https://doi.org/10.21292/2075-1230-2018-96-4-52-57
Abstract
The significance of lipoarabinomannan (LAM) level in blood serum for the confirmation of tuberculosis was analyzed in 106 patients at the advanced stages of HIV infection. In 63 of 106 (59.4%) persons tuberculosis was diagnosed based on clinical signs. Patients with co-infection (HIV/TB) had confidently higher level of LAM in their blood serum versus HIV patients (13.75 ± 1.5 pg/ml; CI ± 2.97 and 7.49 ± 0.5 pg/ml; CI ± 0.96, respectively; Р = 0.000163). In general, sensitivity of the test of LAM level in blood serum of HIV patients made 85.7%, and specificity made 79.1%. It was found out that in TB/HIV patients, LAM level in blood serum was not influenced by such factors as extent of tuberculous lesions in respiratory organs (a positive result of LAM test in case of disseminated and local respiratory lesions was in 86% (37/43) and 85% of cases (17/20) respectively) and bacillary excretion (a positive result of LAM test in case of bacillary excretion and without was in 89.2% (33/37) and 76.9% (20/26) of cases respectively). The part of positive results when performing LAM test was in 87.5% of cases (54/63), while results of skin test with tuberculous recombinant allergen were positive only in 14.4% (9/63). The presented results allow concluding than it would be sensible to test LAM level in blood serum in the patients at the advanced stage of HIV infection. The informativeness of LAM test increases depending as the immune deficiency progresses and it becomes a valuable diagnostic tool at the level of CD4 < 200 cells per mcl.
About the Authors
A. V. Dudchenko
Central Research Institute of Tuberculosis;
Rabukhin Tuberculosis Hospital
Russian Federation
Russian Federation
Post-Graduate Student
2, Yauzskaya Alleya, Moscow, 107564
N. L. Kаrpinа
Central Research Institute of Tuberculosis
Russian Federation
Doctor of Medical Sciences, Head of Clinical Diagnostic Department
Russian Federation
Doctor of Medical Sciences, Head of Clinical Diagnostic Department
M. M. Аverbаkh
Central Research Institute of Tuberculosis
Russian Federation
Doctor of Medical Sciences, Professor, Senior Researcher
Russian Federation
Doctor of Medical Sciences, Professor, Senior Researcher
References
1. Vaneeva T.V., Kulikovskaya N.V., Krasnova M.А., Bondarenko G.V., Rymanova I.V., Sobkin А.L., Safonova S.G. Results of immunological diagnostics methods of tuberculosis in vivo and in vitro in HIV patients, Tuberkulez i Sotsialno-Znachimye Zabolevaniya, 2016, no. 2, pp. 66-71. (In Russ.)
2. Vaneeva T.А., Sinitsyn M.V., Kulikovskaya N.V., Safonova S.G., Аyusheva L.B., Galstyan А.S. Immunological tests for diagnostics of tuberculosis infection in people living with HIV. Tuberkulez i Sotsialno-Znachimye Zabolevaniya, 2017, no. 4, pp. 36-39. (In Russ.)
3. Vasilyeva E.V., Panteleev А.M., Verbov V.N., Totolyan А.А. Value of quantiferron test and IP-10 in diagnostics of tuberculosis in HIV patients. Meditsinskaya Immunologiya. (Immunologiya Tuberkuleza, Special Issue), 2015, 17, pp. 131-132. (In Russ.)
4. Kozhnaya proba s preparatom Diaskintest - novye vozmozhnosti identifikatsii tuberkuleznoy infektsii. [Skin test with the use of Diaskintest - new opportunities for tuberculous infection identification]. M.A. Paltsev, eds., Moscow, Meditsina Publ., 2010, 176 p.
5. Manina V.V., Starshinova А.А., Panteleev А.M., Zhuravlev V.Yu., Pavlova M.V. Sapozhnikova N.V., Yablonsky P.K.Value of various immunological tests in diagnostics of tuberculosis in HIV patients. Meditsinsky Alyans, 2015, no. 1, pp. 220-221. (In Russ.)
6. Nechaeva O.B. Tuberculosis situation among HIV positive people in the Russian Federation. Tuberculosis and Lung Diseases, 2017, vol. 95, no. 3, pp. 13-19. (In Russ.)
7. Achkar J.M., Jenny-Avital E., Yu X., Burger S., Leibert E., Bilder P.W., Almo S.C., Casadevall A., Laal S. Antibodies against Immunodominant Antigens of Mycobacterium tuberculosis in Subjects with Suspected Tuberculosis in the United States Compared by HIV Status. Clin. Vac. Immunol., 2010, vol. 17, pp. 384-392.
8. Briken V., Porcelli S.A., Besra G.S., Kremer L. Mycobacterial lipoarabinomannan and related lipoglycans: from biogenesis to modulation of the immune response. Mol. Microbiol., 2004, vol. 53, pp. 391e 403.
9. Lawn S.D., Butera S.T., Folks T.M. Contribution of immune activation to the pathogenesis and transmission of human immunodeficiency virus type 1 infection. Clin. Microbiol. Rev., 2001, vol. 14, pp. 753-777.
10. Mingli Liu, Shanchun Guo, Jacqueline M. Hibbert, Vidhan Jain, Neeru Singh, Nana O. Wilson, Jonathan K. Stiles. CXCL10/IP-10 in Infectious Diseases Pathogenesis and Potential Therapeutic Implications. Cytokine Growth Factor Rev., 2011, vol. 22, pp. 121-130.
11. Stephen D. Lawna,b, Ankur Gupta-Wrighta. Detection of lipoarabinomannan (LAM) in urine is indicative of disseminated TB with renal involvement in patients living with HIV and advanced immunodeficiency: evidence and implications. Trans. R. Soc. Trop. Med. Hyg., 2016, vol. 110, pp. 180-218.
Review
For citations:
Dudchenko A.V., Kаrpinа N.L., Аverbаkh M.M. OPPORTUNITIES OF IMMUNODIAGNOSTICS OF TUBERCULOSIS IN THE PATIENTS AT ADVANCED STAGES OF HIV INFECTION. Tuberculosis and Lung Diseases. 2018;96(4):52-57. (In Russ.) https://doi.org/10.21292/2075-1230-2018-96-4-52-57
Views:
1149
Email this article 