Journal Article

ESAT-6 and CFP-10 can be combined to reduce the cost of testing for Mycobacterium tuberculosis infection, but CFP-10 responses associate with active disease

Annette Fox, David J. Jeffries, Philip C. Hill, Abdulrahman S. Hammond, Moses D. Lugos, Dolly Jackson-Sillah, Simon A. Donkor, Patrick K. Owiafe, Keith P.W.J. McAdam and Roger H. Brookes

in Transactions of The Royal Society of Tropical Medicine and Hygiene

Published on behalf of Royal Society of Tropical Medicine and Hygiene

Volume 101, issue 7, pages 691-698
Published in print July 2007 | ISSN: 0035-9203
Published online July 2007 | e-ISSN: 1878-3503 | DOI: https://dx.doi.org/10.1016/j.trstmh.2007.03.001
ESAT-6 and CFP-10 can be combined to reduce the cost of testing for Mycobacterium tuberculosis infection, but CFP-10 responses associate with active disease

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Summary

Commercial tests measuring IFN-γ responses to ESAT-6 and CFP-10 are available for diagnosing Mycobacterium tuberculosis infection. Measures that minimize cost and complexity will facilitate their application in less-developed countries. We investigated whether overlapping peptides representing both ESAT-6 and CFP-10 are required to detect M. tuberculosis infection in a high TB-burden country, and whether they can be combined in a single pool. ESAT-6 and CFP-10 peptides were compared in IFN-γ enzyme-linked immunospot (ELISPOT) in 183 HIV-negative smear-positive TB cases and 1673 HIV-negative household contacts. Separate peptide pools for each antigen were compared with a combined pool in 498 contacts. Forty per cent of responsive contacts recognized both antigens, 51% only ESAT-6 and 10% only CFP-10, whereas 56% of responsive cases recognized both antigens, 30% only ESAT-6 and 13% only CFP-10. Accordingly, CFP-10 response rates were higher for TB cases (odds ratio 2.409, P < 0.001). Low purified protein derivative response rates indicated that responses to CFP-10 only were non-specific in contacts. Agreement between peptides in separate versus combined pools was good (κ = 0.758, r = 0.840). Therefore a combined ESAT-6/CFP-10 peptide pool provided maximum sensitivity and efficiency, but CFP-10 was mainly required to detect active disease.

Keywords: Tuberculosis; Infection; Disease; ESAT-6; CFP-10; ELISPOT

Journal Article.  4186 words.  Illustrated.

Subjects: Clinical Medicine ; Infectious Diseases ; Immunology ; Medical Microbiology and Virology ; Public Health and Epidemiology

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