Diagnostic utility of the estimation of mycobacterial Antigen A60 specific immunoglobulins IgM, IgA and IgG in the sera of cases of adult human tuberculosis.
METHODS
An ELISA assay based on mycobacterial Antigen A60 for the estimation of Mycobacterium-specific immunoglobulins in the serum has been used successfully for the rapid diagnosis of tuberculosis in studies done in the Western countries. There are hardly any similar large scale studies in India.


OBJECTIVE
To evaluate the utility of this ELISA test for rapid diagnosis of different clinical forms of tuberculosis in an adult Indian population.


METHODS
ELISA test based on mycobacterial antigen A60 (Anda Biologicals, France) was used to estimate specific IgM, IgA and IgG antibodies in the sera obtained from 337 cases of tuberculosis and 131 controls in the population of Delhi (India).


RESULTS
Of the 131 controls, only 9.9% were positive for IgM, 7.6% for IgG, 6.1% for IgA and 9.9% when an IgA and IgG combination was considered. Of 122 cases of active pulmonary tuberculosis, 41% were positive for IgM, 86.8% for IgA, 88.5% for IgG and a very high positivity (98.3%) was seen when IgA and IgG estimations were combined. A relatively low seropositivity was observed in 25 cases of pleural tuberculosis. The corresponding figures in 130 cases of extrapulmonary tuberculosis were 22.3%, 68.4%, 73.8% and 86.15%. When 60 cases of pulmonary tuberculosis who had been successfully treated with antituberculosis drugs were analyzed the rates of seropositivity fell to 11.6%, 46.6%, 58.3% and 66.6% respectively.


CONCLUSIONS
Our findings point to a very good sensitivity (91.6%) and specificity (90.0%) of the test when combined IgA and IgG antibody titres are considered, to detect cases of adult tuberculosis. The role of IgM estimation can be restricted to the detection of cases of reactivation of tuberculosis.
D000328:Adult; D000907:Antibodies, Bacterial / Q000032:analysis*; D000918:Antibody Specificity; D000942:Antigens, Bacterial / Q000276:immunology*; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006801:Humans; D007070:Immunoglobulin A / Q000032:analysis*; D007074:Immunoglobulin G / Q000032:analysis*; D007075:Immunoglobulin M / Q000032:analysis*; D008297:Male; D009163:Mycobacterium bovis / Q000276:immunology*; D013997:Time Factors; D014376:Tuberculosis / Q000175:diagnosis*; D014396:Tuberculosis, Pleural / Q000175:diagnosis; D014397:Tuberculosis, Pulmonary / Q000175:diagnosis
D000907:Antibodies, Bacterial; D000942:Antigens, Bacterial; D007070:Immunoglobulin A; D007074:Immunoglobulin G; D007075:Immunoglobulin M