Humoral response to Mycobacterium tuberculosis-specific antigens in African tuberculosis patients with high prevalence of human immunodeficiency virus infection.
METHODS
The applicability of serodiagnosis of tuberculosis using Mycobacterium tuberculosis-complex-specific antigens in a Tanzanian population with high prevalence of HIV.


OBJECTIVE
This study was performed to evaluate the usefulness, sensitivity and specificity of serology using M. tuberculosis-specific antigens in the diagnosis of tuberculosis in patients with and without HIV co-infection.


METHODS
Patients with proven pulmonary and extrapulmonary tuberculosis at a major referral centre in Tanzania were enrolled in the study. The control group consisted of patients without a history of previous tuberculosis admitted to the trauma ward and of healthy volunteers. Sera were analysed by an enzyme linked immunoassay (ELISA) using two M. tuberculosis specific proteins as antigen: the 38 kDa protein [3T] and a 17 kDa protein. In addition was recorded presence or absence of BCG scar and tuberculin sensitivity and the sera were tested for HIV and analysed for beta-2-microglobulin content.


RESULTS
Sensitivity and specificity were markedly reduced in tuberculosis patients with HIV co-infection compared to patients without this disease (73% and 70% versus 52% and 50% respectively).


CONCLUSIONS
Serology for diagnosis of tuberculosis is not feasible in an HIV endemic region.
Thybo
S
S
Department of Mycobacteria, Statens Seruminstitut, Copenhagen, Denmark.
Richter
C
C
Wachmann
H
H
Maselle
S Y
SY
Mwakyusa
D H
DH
Mtoni
I
I
Andersen
A B
AB
D000907:Antibodies, Bacterial / Q000096:biosynthesis*; D004797:Enzyme-Linked Immunosorbent Assay; D000939:Epitopes / Q000276:immunology*; D015658:HIV Infections / Q000150:complications*; D006801:Humans; D009169:Mycobacterium tuberculosis / Q000276:immunology*; D012680:Sensitivity and Specificity; D014374:Tuberculin Test; D014376:Tuberculosis / Q000150:complications / Q000175:diagnosis / Q000276:immunology*
D000907:Antibodies, Bacterial; D000939:Epitopes