Imperial College London
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PROFESSOR AJIT LALVANI

Faculty of Medicine, National Heart & Lung Institute

Chair in Infectious Diseases
 
 
 
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Contact

 

+44 (0)20 7594 0883a.lalvani

 
 
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Assistant

 

Dr Luis Berrocal Almanza +44 (0)20 7594 3721

 
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Location

 

Medical SchoolSt Mary's Campus

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Summary

 

Publications

Citation

BibTex format

@article{Halliday:2022:infdis/jiab311,
author = {Halliday, A and Masonou, T and Tolosa-Wright, MR and Guo, Y and Hoang, L and Parker, R and Boakye, A and Takwoingi, Y and Badhan, A and Jain, P and Marwah, I and Berrocal-Almanza, LC and Deeks, J and Beverley, P and Kon, OM and Lalvani, A},
doi = {infdis/jiab311},
journal = {Journal of Infectious Diseases},
pages = {1632--1641},
title = {Defining the role of cellular immune signatures in diagnostic evaluation of suspected tuberculosis},
url = {http://dx.doi.org/10.1093/infdis/jiab311},
volume = {225},
year = {2022}
}
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RIS format (EndNote, RefMan)

TY  - JOUR
AB  - BACKGROUND: Diagnosis of paucibacillary tuberculosis (TB) including extrapulmonary TB is a significant challenge, particularly in high-income, low-incidence settings. Measurement of Mycobacterium tuberculosis (Mtb)-specific cellular immune signatures by flow cytometry discriminates active TB from latent TB infection (LTBI) in case-control studies; however, their diagnostic accuracy and clinical utility in routine clinical practice is unknown. METHODS: Using a nested case-control study design within a prospective multicenter cohort of patients presenting with suspected TB in England, we assessed diagnostic accuracy of signatures in 134 patients who tested interferon-gamma release assay (IGRA)-positive and had final diagnoses of TB or non-TB diseases with coincident LTBI. Cellular signatures were measured using flow cytometry. RESULTS: All signatures performed less well than previously reported. Only signatures incorporating measurement of phenotypic markers on functional Mtb-specific CD4 T cells discriminated active TB from non-TB diseases with LTBI. The signatures measuring HLA-DR+IFNγ+ CD4 T cells and CD45RA-CCR7-CD127- IFNγ-IL-2-TNFα+ CD4 T cells performed best with 95% positive predictive value (95% confidence interval, 90-97) in the clinically challenging subpopulation of IGRA-positive but acid-fast bacillus (AFB) smear-negative TB suspects. CONCLUSIONS: Two cellular immune signatures could improve and accelerate diagnosis in the challenging group of patients who are IGRA-positive, AFB smear-negative, and have paucibacillary TB.
AU  - Halliday,A
AU  - Masonou,T
AU  - Tolosa-Wright,MR
AU  - Guo,Y
AU  - Hoang,L
AU  - Parker,R
AU  - Boakye,A
AU  - Takwoingi,Y
AU  - Badhan,A
AU  - Jain,P
AU  - Marwah,I
AU  - Berrocal-Almanza,LC
AU  - Deeks,J
AU  - Beverley,P
AU  - Kon,OM
AU  - Lalvani,A
DO  - infdis/jiab311
EP  - 1641
PY  - 2022///
SN  - 0022-1899
SP  - 1632
TI  - Defining the role of cellular immune signatures in diagnostic evaluation of suspected tuberculosis
T2  - Journal of Infectious Diseases
UR  - http://dx.doi.org/10.1093/infdis/jiab311
UR  - https://www.ncbi.nlm.nih.gov/pubmed/34331451
UR  - http://hdl.handle.net/10044/1/91594
VL  - 225
ER  -
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