Abstract
Tuberculosis remains a major public health problem. Conventional tests are inadequate to distinguish between active tuberculosis (ATB) and latent tuberculosis infection (LTBI). We measured antibody responses to Mycobacterium tuberculosis antigens (Mycobacterium tuberculosis chorismate mutase (TBCM), antigen 85B (Ag85B), early secreted antigen-6 (ESAT-6), and culture filtrate protein-10 (CFP-10) in ATB, LTBI, and non-infected (NI) individuals. Serum immunoglobulin G (IgG) and immunoglobulin A (IgA) levels were measured and the QuantiFERON-TB Gold In-Tube assay was used to diagnose LTBI. IgG levels against TBCM were significantly higher in LTBI than NI subjects. IgG and IgA levels against Ag85B and IgG levels against CFP-10 were significantly higher in ATB, followed by LTBI, and then NI. When the ATB group was subdivided, IgG levels against Ag85B and CFP-10 were significantly higher in each subgroup compared with those in LTBI and NI groups. Positive correlation trends between interferon-gamma and IgG levels against Ag85B, TBCM, and CFP-10 and IgA levels against Ag85B in LTBI and NI subjects were observed. Age- and sex-adjusted models showed that IgG against TBCM and CFP-10 was independently related to LTBI diagnosis, and IgG against Ag85B was independently related to the diagnosis of ATB and could distinguish between LTBI and ATB. Overall, IgG antibody responses to TBCM, Ag85B, and CFP-10 can discriminate among ATB, LTBI, and NI groups.
Highlights
Tuberculosis (TB) remains a major public health problem
The inclusion criteria allowed for men and women over 19 years of age, who were diagnosed with active tuberculosis (ATB) or were targeted for the examination of latent tuberculosis infection (LTBI) at the National Medical Center, Seoul, Republic of Korea
The subjects selected for LTBI examination were tested with the QuantiFERON-TB Gold In-Tube (QFT-GIT) assay
Summary
Tuberculosis (TB) remains a major public health problem. In 2018, 7.0 million new cases of TB were reported worldwide, as well as an estimated 1.2 million TB deaths among human immunodeficiency virus (HIV)-negative people and an additional 251,000 deaths among HIV-positive people [1]. In South Korea, 26,433 new TB cases (51.5 cases per 100,000 people) were reported in 2018 [2]. Since the establishment of the national TB control program in 1962 [3], the number of reported pulmonary TB patients in South Korea has rapidly declined, from 101 per 100,000 people in 1995 to 79 in 2002. The rapid diagnosis and treatment of TB is essential to contain the disease at an early stage and to lower its prevalence. Diagnosis and treatment of latent tuberculosis infection (LTBI) as well as active tuberculosis (ATB) are required for effective TB control. As latent TB bacilli could reactivate later to cause active TB, diagnosis and treatment of LTBI is important
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