Acute phase proteins and IP-10 as triage tests for the diagnosis of tuberculosis: systematic review and meta-analysis
Por:
Santos, VS, Goletti, D, Kontogianni, K, Adams, ER, Molina-Moya, B, Dominguez, J, Crudu, V, Martins, PRS, Ruhwald, M, Lawson, L, Bimba, JS, Garcia-Basteiro, AL, Petrone, L, Kabeer, BS, Reither, K and Cuevas, LE
Publicada:
1 feb 2019
Ahead of Print:
2 ago 2018
Resumen:
Objectives: We examined the data reported in studies for diagnostic purposes and to discuss whether their intended use could be extended to triage, as rule-in or rule-out tests to select individuals who should undergo further confirmatory tests.
Methods: We searched Scopus, PubMed andWeb of Science with the terms 'acute phase proteins,' 'IP-10,' 'tuberculosis,' 'screening' and 'diagnosis,' extracted the sensitivity and specificity of the biomarkers and explored methodologic differences to explain performance variations. Summary estimates were calculated using random-effects models for overall pooled accuracy. The hierarchical summary receiver operating characteristic model was used for meta- analysis.
Results: We identified 14, four and one studies for C-reactive protein (CRP), interferon geinduced protein 10 (IP-10) and alpha-1-acid glycoprotein (AGP). The pooled CRP sensitivity/specificity (95% confidence interval) was 89% (80-96) and 57% (36-65). Sensitivity/specificity were higher in high-tuberculosisburden countries (90%/64%), HIV-infected individuals (91%/61%) and community-based studies (90%/ %). IP-10 sensitivity/specificity in TB vs. non- TB studies was 85%/63% and in TB and HIV coinfected vs. other lung conditions 94%/21%. However, IP-10 studies included diverse populations and a high risk of bias, resulting in very low-quality evidence. AGP had 86%/93% sensitivity/specificity.
Conclusions: Few studies have evaluated CRP, IP-10 and AGP for the triage of symptomatic patients. Their high sensitivity and moderate specificity warrant further prospective studies exploring whether their combined use could optimize performance. (C) 2018 The Authors. Published by Elsevier Ltd.
Filiaciones:
Santos, VS:
Univ Fed Alagoas, Ctr Epidemiol & Publ Hlth, Arapiraca, Brazil
Goletti, D:
IRCCS, Dept Clin & Clin Res, L Spallanzani Natl Inst Infect Dis INMI, Rome, Italy
Kontogianni, K:
Univ Liverpool Liverpool Sch Trop Med, Pembroke Pl, Liverpool L3 5QA, Merseyside, England
Adams, ER:
Univ Liverpool Liverpool Sch Trop Med, Pembroke Pl, Liverpool L3 5QA, Merseyside, England
:
Univ Autonoma Barcelona, Hosp Univ Germans Trias & Pujol, Inst Invest Germans Trias & Pujol, Serv Microbiol, Carretera Canyet S-N, Badalona 08916, Spain
:
Univ Autonoma Barcelona, Hosp Univ Germans Trias & Pujol, Inst Invest Germans Trias & Pujol, Serv Microbiol, Carretera Canyet S-N, Badalona 08916, Spain
Crudu, V:
Phthisiopneumol Inst Chiril Draganiuc, Natl TB Reference Lab, Chisinau, Maldives
Martins, PRS:
Univ Fed Sergipe, Invest Pathol Lab, Aracaju, Brazil
Ruhwald, M:
Statens Serum Inst, Ctr Vaccine Res, Copenhagen, Denmark
Lawson, L:
Bingham Univ, Zankli Res Lab, Karu, Nassarawa State, Nigeria
Bimba, JS:
Bingham Univ, Zankli Res Lab, Karu, Nassarawa State, Nigeria
Garcia-Basteiro, AL:
CISM, Rua 12,Cambeve CP 1929, Maputo, Mozambique
Amsterdam Inst Global Hlth AIGHD, Amsterdam, Netherlands
Barcelona Inst Global Hlth ISGlobal, Barcelona, Spain
Petrone, L:
IRCCS, Dept Clin & Clin Res, L Spallanzani Natl Inst Infect Dis INMI, Rome, Italy
Kabeer, BS:
IRCCS, Dept Clin & Clin Res, L Spallanzani Natl Inst Infect Dis INMI, Rome, Italy
Reither, K:
Swiss Trop & Publ Hlth Inst, Basel, Switzerland
Univ Basel, Basel, Switzerland
Cuevas, LE:
Univ Liverpool Liverpool Sch Trop Med, Pembroke Pl, Liverpool L3 5QA, Merseyside, England
hybrid, Green Accepted
|