Novel TB Test Identified for Patients With HIV

A novel 5-transcript signature is accurate for screening for tuberculosis (TB) in patients with HIV, according to research findings.

To come to this conclusion, the researchers enrolled patients with culture-confirmed TB (n = 40) with time-matched controls (n = 80) between July 2013 and April 2015. All patients had HIV and were living in Kampala, Uganda.

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Then the participants were randomly assigned to either a training (n = 80) or a test (n = 40) dataset.

“We used the training dataset to derive candidate signatures that consisted of 1 to 5 differentially expressed transcripts and compared the performance of our candidate signatures with 4 published TB gene-expression signatures, both on the independent test dataset and in 2 external datasets,” the researchers wrote.

In the end, the researchers identified a novel, 5-transcript signature that was capable of accurately diagnosing TB. The independent test dataset had a sensitivity of 94% and a specificity of 75%.

“Our novel signature performed well in external datasets from both high (AUC 0.81, 95% CI 0.74-0.88) and low (0.81, 95% CI 0.77-0.85) TB burden settings,” the researchers concluded.

“Our signature has the potential to be translated into a point-of-care test to facilitate systematic TB screening among [people living with HIV] and other high-risk populations.”

—Amanda Balbi

Reference:

Rajan JV, Semtiala FC, Mehta T, et al. A novel, 5-transcropt, whole-blood gene-expression signature for tuberculosis screening among people living with human immunodeficiency virus. Clin Infect Dis. 2019;69(1):77-83. https://doi.org/10.1093/cid/ciy835.