4.7 Article

A transcriptional blood signature distinguishes early tuberculosis disease from latent tuberculosis infection and uninfected individuals in a Vietnamese cohort

期刊

JOURNAL OF INFECTION
卷 81, 期 1, 页码 72-80

出版社

W B SAUNDERS CO LTD
DOI: 10.1016/j.jinf.2020.03.066

关键词

Biomarker; Gene signature; Tuberculosis screening; Active case finding; Tuberculosis diagnosis

资金

  1. Australian National Health and Medical Research Council (NHMRC) [APP1045236]
  2. NHMRC Centre of Research Excellence in TB Control (TB-CRE) [APP1043225]
  3. AERAS Foundation for TB Vaccines

向作者/读者索取更多资源

Objectives: Global tuberculosis (TB) control is restricted by the failure to detect an estimated 3.3 million TB cases annually. In the majority of TB endemic settings, sputum smear microscopy is used to diagnose TB, but this test is insensitive for TB in its early stages. The objective of this study is to establish a concise gene signature that discriminates between individuals with early TB disease, latent TB infection (LTBI) and those without infection. Methods: This is a case control study nested within a cluster-randomised trial of population screening for active TB using Xpert MTB/RIF. Whole blood samples from 303 participants with active TB (97), LTBI (92) and uninfected individuals (114) were subject to transcriptomic analysis of selected target genes based on a systematic review of previous studies. Results: Analysis of 82 genes identified a pattern of differentially expressed genes in TB disease. A seven gene signature was identified that distinguished between TB disease and no TB disease with an AUC of 0.86 (95% CI: 0.80-0.91), and between TB disease from LTBI with an AUC of 0.88 (95% CI: 0.82-0.93). Conclusion: This gene signature accurately distinguishes early TB disease from those without TB disease or infection, in the context of community-wide TB screening. It could be used as a non-sputum based screening tool or triage test to detect prevalent cases of TB in the community. (C) 2020 The British Infection Association. Published by Elsevier Ltd. All rights reserved.

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