A blood-based 3-gene signature score for therapeutic monitoring in patients with pulmonary tuberculosis.
Tuberculosis (Edinb)
; 147: 102521, 2024 Jul.
Article
em En
| MEDLINE
| ID: mdl-38801793
ABSTRACT
OBJECTIVE:
To assess the validity of Xpert Tuberculosis Fingerstick score for monitoring treatment response and analyze factors influencing its performance.METHODS:
122 adults with pulmonary tuberculosis were recruited and stratified into three cohorts Diabetic-drug-susceptible-TB (DM-TB), Non-diabetic-drug-susceptible-TB (NDM-TB) and Non-diabetic Multidrug-resistant TB (MDR-TB). Fingerstick blood specimens were tested at treatment initiation (M0) and the end of the first (M1), second (M2), and sixth month (M6) to generate a TB-score.RESULTS:
The TB-score in all participants yielded an AUC of 0.707 (95% CI 0.579-0.834) at M2 when its performance was evaluated against sputum culture conversion. In all non-diabetes patients, the AUC reached 0.88 (95% CI 0.756-1.000) with an optimal cut-off value of 1.95 at which sensitivity was 90.0% (95% CI 59.6-98.2%) and specificity was 81.3% (95% CI 70.0-88.9%). The mean TB score was higher in patients with low bacterial loads (n = 31) than those with high bacterial loads (n = 91) at M0, M1, M2, and M6, and was higher in non-cavitary patients (n = 71) than those with cavitary lesions (n = 51) at M0, M1, and M2.CONCLUSION:
Xpert TB-score shows promising predictive value for culture conversion in non-diabetic TB patients. Sputum bacterial load and lung cavitation status have an influence on the value of TB score.Palavras-chave
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Base de dados:
MEDLINE
Assunto principal:
Escarro
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Tuberculose Pulmonar
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Valor Preditivo dos Testes
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Mycobacterium tuberculosis
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Antituberculosos
Limite:
Adult
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Aged
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Female
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Humans
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Male
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Middle aged
Idioma:
En
Ano de publicação:
2024
Tipo de documento:
Article