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Heparin-binding haemagglutinin, a new tool for the detection of latent Mycobacterium tuberculosis infection in hemodialysis patients.

Dessein R, Corbière V, Nortier J, Dratwa M, Gastaldello K, Pozdzik A, Lecher S, Grandbastien B, Locht C, Mascart F - PLoS ONE (2013)

Bottom Line: Seven patients had a past history of active TB and 1 had an undetermined result with both IGRAs.Discrepant results between these tests were found for 36 patients positive only with the nHBHA-IGRA and 5 only with the QFT.The nHBHA-IGRA is more sensitive than the QFT for the detection of LTBI dialysis patients, and follow-up of the patients will allow us to define the clinical significance of discrepant results between the nHBHA-IGRA and the QFT.

View Article: PubMed Central - PubMed

Affiliation: Laboratory of Vaccinology and Mucosal Immunity, Université Libre de Bruxelles, Brussels, Belgium.

ABSTRACT

Background: Patients with end-stage renal disease (ESRD) and latently infected with Mycobacterium tuberculosis (LTBI) are at higher risk to develop tuberculosis (TB) than healthy subjects. Interferon-gamma release assays (IGRAs) were reported to be more sensitive than tuberculin skin tests for the detection of infected individuals in dialysis patients.

Methods: On 143 dialysis patients prospectively enrolled, we compared the results from the QuantiFERON®-TB Gold assay (QFT), to those of an IGRA in response to in vitro stimulation of circulating mononuclear cells with the mycobacterial latency antigen Heparin-Binding Haemagglutinin purified from Mycobacterium bovis BCG (native HBHA, nHBHA).

Results: Seven patients had a past history of active TB and 1 had an undetermined result with both IGRAs. Among the other 135 patients, 94 had concordant results with the QFT and nHBHA-IGRA, 40.0% being negative and therefore not latently infected, and 29.6% being positive and thus LTBI. Discrepant results between these tests were found for 36 patients positive only with the nHBHA-IGRA and 5 only with the QFT.

Conclusions: The nHBHA-IGRA is more sensitive than the QFT for the detection of LTBI dialysis patients, and follow-up of the patients will allow us to define the clinical significance of discrepant results between the nHBHA-IGRA and the QFT.

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Related in: MedlinePlus

Positive nHBHA-IGRA results in QFT positive or negative HD patients.PBMC freshly isolated from whole blood of 135 HD patients were incubated 24 hrs in presence of nHBHA (2 µg/ml) with 5 ng/ml IL-7, and the IFN-γ concentrations released in the cell cultures supernatants were measured by ELISA. Seventy-six subjects were nHBHA-IGRA positive. QFT was performed simultaneously and each dot represents a positive nHBHA-IGRA result (expressed in pg/ml) for single patient presenting either a positive QFT (QFT+ = 40) or a negative QFT (QFT− = 36). Horizontal bars represent the medians of the results.
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pone-0071088-g003: Positive nHBHA-IGRA results in QFT positive or negative HD patients.PBMC freshly isolated from whole blood of 135 HD patients were incubated 24 hrs in presence of nHBHA (2 µg/ml) with 5 ng/ml IL-7, and the IFN-γ concentrations released in the cell cultures supernatants were measured by ELISA. Seventy-six subjects were nHBHA-IGRA positive. QFT was performed simultaneously and each dot represents a positive nHBHA-IGRA result (expressed in pg/ml) for single patient presenting either a positive QFT (QFT+ = 40) or a negative QFT (QFT− = 36). Horizontal bars represent the medians of the results.

Mentions: The nHBHA-IGRA was positive for the 7 patients with a previous history of active TB. Among the others, one patient had an undetermined result for the nHBHA-IGRA like for the QFT, and 76 had a positive test (56.3%), with a median value of IFN-γ release of 687 pg/ml (range: 106–43,322). Among these, 40 had also a positive QFT (Figure 1), and the nHBHA-induced IFN-γ concentrations were similar in the QFT positive compared to the QFT negative group (Figure 3). As for the QFT results, a weak association was found between the nHBHA-IGRA positivity and the male gender (OR 2.60, Table 2). The nHBHA-IGRA was positive for 53/69 (77%) and 23/66 (35%) of the patients from high and low TB-incidence countries, respectively. This means that among the patients with a positive nHBHA-IGRA, 69.7% were born in a high prevalence country, compared to 30.3% born in Western countries. Strong associations were noted between the positivity of the nHBHA-IGRA and the country of origin (OR 9.93 for Eastern Europe, OR 9.48 for North Africa, and OR 3.51 for Western Africa, Table 2). In contrast, no association was observed between ESRD etiologies and the nHBHA-IGRA positivity.


Heparin-binding haemagglutinin, a new tool for the detection of latent Mycobacterium tuberculosis infection in hemodialysis patients.

Dessein R, Corbière V, Nortier J, Dratwa M, Gastaldello K, Pozdzik A, Lecher S, Grandbastien B, Locht C, Mascart F - PLoS ONE (2013)

Positive nHBHA-IGRA results in QFT positive or negative HD patients.PBMC freshly isolated from whole blood of 135 HD patients were incubated 24 hrs in presence of nHBHA (2 µg/ml) with 5 ng/ml IL-7, and the IFN-γ concentrations released in the cell cultures supernatants were measured by ELISA. Seventy-six subjects were nHBHA-IGRA positive. QFT was performed simultaneously and each dot represents a positive nHBHA-IGRA result (expressed in pg/ml) for single patient presenting either a positive QFT (QFT+ = 40) or a negative QFT (QFT− = 36). Horizontal bars represent the medians of the results.
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC3733734&req=5

pone-0071088-g003: Positive nHBHA-IGRA results in QFT positive or negative HD patients.PBMC freshly isolated from whole blood of 135 HD patients were incubated 24 hrs in presence of nHBHA (2 µg/ml) with 5 ng/ml IL-7, and the IFN-γ concentrations released in the cell cultures supernatants were measured by ELISA. Seventy-six subjects were nHBHA-IGRA positive. QFT was performed simultaneously and each dot represents a positive nHBHA-IGRA result (expressed in pg/ml) for single patient presenting either a positive QFT (QFT+ = 40) or a negative QFT (QFT− = 36). Horizontal bars represent the medians of the results.
Mentions: The nHBHA-IGRA was positive for the 7 patients with a previous history of active TB. Among the others, one patient had an undetermined result for the nHBHA-IGRA like for the QFT, and 76 had a positive test (56.3%), with a median value of IFN-γ release of 687 pg/ml (range: 106–43,322). Among these, 40 had also a positive QFT (Figure 1), and the nHBHA-induced IFN-γ concentrations were similar in the QFT positive compared to the QFT negative group (Figure 3). As for the QFT results, a weak association was found between the nHBHA-IGRA positivity and the male gender (OR 2.60, Table 2). The nHBHA-IGRA was positive for 53/69 (77%) and 23/66 (35%) of the patients from high and low TB-incidence countries, respectively. This means that among the patients with a positive nHBHA-IGRA, 69.7% were born in a high prevalence country, compared to 30.3% born in Western countries. Strong associations were noted between the positivity of the nHBHA-IGRA and the country of origin (OR 9.93 for Eastern Europe, OR 9.48 for North Africa, and OR 3.51 for Western Africa, Table 2). In contrast, no association was observed between ESRD etiologies and the nHBHA-IGRA positivity.

Bottom Line: Seven patients had a past history of active TB and 1 had an undetermined result with both IGRAs.Discrepant results between these tests were found for 36 patients positive only with the nHBHA-IGRA and 5 only with the QFT.The nHBHA-IGRA is more sensitive than the QFT for the detection of LTBI dialysis patients, and follow-up of the patients will allow us to define the clinical significance of discrepant results between the nHBHA-IGRA and the QFT.

View Article: PubMed Central - PubMed

Affiliation: Laboratory of Vaccinology and Mucosal Immunity, Université Libre de Bruxelles, Brussels, Belgium.

ABSTRACT

Background: Patients with end-stage renal disease (ESRD) and latently infected with Mycobacterium tuberculosis (LTBI) are at higher risk to develop tuberculosis (TB) than healthy subjects. Interferon-gamma release assays (IGRAs) were reported to be more sensitive than tuberculin skin tests for the detection of infected individuals in dialysis patients.

Methods: On 143 dialysis patients prospectively enrolled, we compared the results from the QuantiFERON®-TB Gold assay (QFT), to those of an IGRA in response to in vitro stimulation of circulating mononuclear cells with the mycobacterial latency antigen Heparin-Binding Haemagglutinin purified from Mycobacterium bovis BCG (native HBHA, nHBHA).

Results: Seven patients had a past history of active TB and 1 had an undetermined result with both IGRAs. Among the other 135 patients, 94 had concordant results with the QFT and nHBHA-IGRA, 40.0% being negative and therefore not latently infected, and 29.6% being positive and thus LTBI. Discrepant results between these tests were found for 36 patients positive only with the nHBHA-IGRA and 5 only with the QFT.

Conclusions: The nHBHA-IGRA is more sensitive than the QFT for the detection of LTBI dialysis patients, and follow-up of the patients will allow us to define the clinical significance of discrepant results between the nHBHA-IGRA and the QFT.

Show MeSH
Related in: MedlinePlus