title: Antibodies against immunodominant antigens of Mycobacterium tuberculosis in subjects with suspected tuberculosis in the United States compared by HIV status.
abstract: The immunodominance of Mycobacterium tuberculosis proteins malate synthase (MS) and MPT51 has been demonstrated in case-control studies with patients from countries in which tuberculosis (TB) is endemic. The value of these antigens for the serodiagnosis of TB now is evaluated in a cross-sectional study of pulmonary TB suspects in the United States diagnosed to have TB, HIV-associated TB, or other respiratory diseases (ORD). Serum antibody reactivity to recombinant purified MS and MPT51 was determined by enzyme-linked immunosorbent assays (ELISAs) of samples from TB suspects and well-characterized control groups. TB suspects were diagnosed with TB (n = 87; 49% sputum microscopy negative, 20% HIV(+)) or ORD (n = 63; 58% HIV(+)). Antibody reactivity to MS and MPT51 was significantly higher in U.S. HIV(+)/TB samples than in HIV(-)/TB samples (P < 0.001), and it was significantly higher in both TB groups than in control groups with latent TB infection (P < 0.001). Antibody reactivity to both antigens was higher in U.S. HIV(+)/TB samples than in HIV(+)/ORD samples (P = 0.052 for MS, P = 0.001 for MPT51) but not significantly different between HIV(-)/TB and HIV(-)/ORD. Among U.S. HIV(+) TB suspects, a positive anti-MPT51 antibody response was strongly and significantly associated with TB (odds ratio, 11.0; 95% confidence interval, 2.3 to 51.2; P = 0.002). These findings have implications for the adjunctive use of TB serodiagnosis with these antigens in HIV(+) subjects.
authors.affiliation: Albert Einstein College of Medicine, Bronx, NY 10461, USA. jacqueline.achkar@einstein.yu.edu
authors.forename: Jacqueline M
authors.initials: JM
authors.lastname: Achkar
authors.forename: Elisabeth
authors.initials: E
authors.lastname: Jenny-Avital
authors.forename: Xian
authors.initials: X
authors.lastname: Yu
authors.forename: Susanne
authors.initials: S
authors.lastname: Burger
authors.forename: Eric
authors.initials: E
authors.lastname: Leibert
authors.forename: Patrick W
authors.initials: PW
authors.lastname: Bilder
authors.forename: Steven C
authors.initials: SC
authors.lastname: Almo
authors.forename: Arturo
authors.initials: A
authors.lastname: Casadevall
authors.forename: Suman
authors.initials: S
authors.lastname: Laal
mesh_terms: D000328:Adult; D000907:Antibodies, Bacterial / Q000097:blood; D000942:Antigens, Bacterial / Q000276:immunology; D001426:Bacterial Proteins / Q000276:immunology; D003430:Cross-Sectional Studies; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D015658:HIV Infections / Q000150:complications*; D006801:Humans; D016056:Immunodominant Epitopes / Q000276:immunology; D055985:Latent Tuberculosis / Q000150:complications / Q000175:diagnosis / Q000276:immunology; D008292:Malate Synthase / Q000276:immunology; D008297:Male; D008875:Middle Aged; D009169:Mycobacterium tuberculosis / Q000276:immunology; D011994:Recombinant Proteins / Q000276:immunology; D014397:Tuberculosis, Pulmonary / Q000150:complications / Q000175:diagnosis* / Q000276:immunology; D014481:United States
chemical_list: D000907:Antibodies, Bacterial; D000942:Antigens, Bacterial; D001426:Bacterial Proteins; D016056:Immunodominant Epitopes; C082911:MPT51 protein, Mycobacterium; D011994:Recombinant Proteins; D008292:Malate Synthase