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Acute phase proteins and IP-10 as triage tests for the diagnosis of tuberculosis : systematic review and meta-analysis

Santos, V. S. and Goletti, D. and Kontogianni, K. and Adams, E. R. and Molina-Moya, B. and Dominguez, J. and Crudu, V. and Martins-Filho, P. R. S. and Ruhwald, M. and Lawson, L. and Bimba, J. S. and Garcia-Basteiro, A. L. and Petrone, L. and Kabeer, B. S. and Reither, K. and Cuevas, L. E.. (2019) Acute phase proteins and IP-10 as triage tests for the diagnosis of tuberculosis : systematic review and meta-analysis. Clinical Microbiology and Infection, 25 (2). pp. 169-177.

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Abstract

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.; We searched Scopus, PubMed and Web 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.; We identified 14, four and one studies for C-reactive protein (CRP), interferon γ-induced 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-tuberculosis-burden countries (90%/64%), HIV-infected individuals (91%/61%) and community-based studies (90%/62%). 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.; 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.
Faculties and Departments:09 Associated Institutions > Swiss Tropical and Public Health Institute (Swiss TPH)
09 Associated Institutions > Swiss Tropical and Public Health Institute (Swiss TPH) > Department of Medicine (MED) > Clinical Research (Reither)
UniBasel Contributors:Reither, Klaus
Item Type:Article, refereed
Article Subtype:Review Article
Publisher:Elsevier
ISSN:1469-0691
e-ISSN:1469-0691
Note:Publication type according to Uni Basel Research Database: Journal article
Language:English
Identification Number:
Last Modified:28 Feb 2019 13:32
Deposited On:28 Feb 2019 13:32

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