Philip Hill and colleagues report that both ELISPOT conversion and reversion occur afterM. tuberculosis exposure in an endemic country and that the ELISPOT results agree poorly with results from the tuberculin skin test

Adegbola

Aiken

Alex M Aiken

Annette Fox

Bellete

Bouke C de Jong

Carrara

Comstock

David J Jeffries

Demissie

Dolly Jackson-Sillah

Edwards

Ewer

Ferrara

Fine

Haile

Heifets

Hill

Ifedayo M Adetifa

Jeffries

Kamerbeek

Keith P McAdam

Lalvani

Menzies

Moses D Lugos

Nicol

Pathan

Philip C Hill

Philip Hopewell

Pouchot

Richard A Adegbola

Richards

Roger H Brookes

Schim

Simon A Donkor

Soysal

van Embden

Wasz-Hockert

Wayne

Wilkinson

English

PubMed

 infection. To address this deficiency, we conducted a longitudinal assessment of the enzyme-linked immunosorbent spot test (ELISPOT) test in comparison to the standard tuberculin skin test (TST). = 0.019); 18 (32.7%) underwent ELISPOT reversion; and five (8.9%) underwent TST reversion. Results in 13 contacts diagnosed as having TB were mixed, but suggested higher TST sensitivity. infection should be interpreted with caution

Hill Philip C

Brookes Roger H

Fox Annette

Jackson-Sillah Dolly

Jeffries David J

Lugos Moses D

Donkor Simon A

Adetifa Ifedayo M

de Jong Bouke C

Aiken Alex M

Adegbola Richard A

McAdam Keith P

Public Library of Science (PLOS)

 Infection

Very little longitudinal information is available regarding the performance of T cell-based tests for Mycobacterium tuberculosis infection. To address this deficiency, we conducted a longitudinal assessment of the enzyme-linked immunosorbent spot test (ELISPOT) test in comparison to the standard tuberculin skin test (TST).In tuberculosis (TB) contacts we repeated ELISPOT tests 3 mo (n = 341) and 18 mo (n = 210) after recruitment and TSTs at 18 mo (n = 130). We evaluated factors for association with conversion and reversion and investigated suspected cases of TB. Of 207 ELISPOT-negative contacts, 51 (24.6%) had 3-mo ELISPOT conversion, which was associated with a positive recruitment TST (odds ratio [OR] 2.2, 95% confidence interval [CI] 1.0-5.0, p = 0.048) and negatively associated with bacillus Calmette-Guérin (BCG) vaccination (OR 0.5, 95% CI 0.2-1.0, p = 0.06). Of 134 contacts, 54 (40.2%) underwent 3-mo ELISPOT reversion, which was less likely in those with a positive recruitment TST (OR 0.3, 95% CI 0.1-0.8, p = 0.014). Between 3 and 18 mo, 35/132 (26.5%) contacts underwent ELISPOT conversion and 28/78 (35.9%) underwent ELISPOT reversion. Of the 210 contacts with complete results, 73 (34.8%) were ELISPOT negative at all three time points; 36 (17.1%) were positive at all three time points. Between recruitment and 18 mo, 20 (27%) contacts had ELISPOT conversion; 37 (50%) had TST conversion, which was associated with a positive recruitment ELISPOT (OR 7.2, 95% CI 1.4-37.1, p = 0.019); 18 (32.7%) underwent ELISPOT reversion; and five (8.9%) underwent TST reversion. Results in 13 contacts diagnosed as having TB were mixed, but suggested higher TST sensitivity.Both ELISPOT conversion and reversion occur after M. tuberculosis exposure. Rapid ELISPOT reversion may reflect M. tuberculosis clearance or transition into dormancy and may contribute to the relatively low reported ELISPOT conversion rate. Therefore, a negative ELISPOT test for M. tuberculosis infection should be interpreted with caution

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PLoS Medicine

Longitudinal assessment of an ELISPOT test for Mycobacterium tuberculosis infection.

BACKGROUND: Very little longitudinal information is available regarding the performance of T cell-based tests for Mycobacterium tuberculosis infection. To address this deficiency, we conducted a longitudinal assessment of the enzyme-linked immunosorbent spot test (ELISPOT) test in comparison to the standard tuberculin skin test (TST). METHODS AND FINDINGS: In tuberculosis (TB) contacts we repeated ELISPOT tests 3 mo (n = 341) and 18 mo (n = 210) after recruitment and TSTs at 18 mo (n = 130). We evaluated factors for association with conversion and reversion and investigated suspected cases of TB. Of 207 ELISPOT-negative contacts, 51 (24.6%) had 3-mo ELISPOT conversion, which was associated with a positive recruitment TST (odds ratio [OR] 2.2, 95% confidence interval [CI] 1.0-5.0, p = 0.048) and negatively associated with bacillus Calmette-Guérin (BCG) vaccination (OR 0.5, 95% CI 0.2-1.0, p = 0.06). Of 134 contacts, 54 (40.2%) underwent 3-mo ELISPOT reversion, which was less likely in those with a positive recruitment TST (OR 0.3, 95% CI 0.1-0.8, p = 0.014). Between 3 and 18 mo, 35/132 (26.5%) contacts underwent ELISPOT conversion and 28/78 (35.9%) underwent ELISPOT reversion. Of the 210 contacts with complete results, 73 (34.8%) were ELISPOT negative at all three time points; 36 (17.1%) were positive at all three time points. Between recruitment and 18 mo, 20 (27%) contacts had ELISPOT conversion; 37 (50%) had TST conversion, which was associated with a positive recruitment ELISPOT (OR 7.2, 95% CI 1.4-37.1, p = 0.019); 18 (32.7%) underwent ELISPOT reversion; and five (8.9%) underwent TST reversion. Results in 13 contacts diagnosed as having TB were mixed, but suggested higher TST sensitivity. CONCLUSIONS: Both ELISPOT conversion and reversion occur after M. tuberculosis exposure. Rapid ELISPOT reversion may reflect M. tuberculosis clearance or transition into dormancy and may contribute to the relatively low reported ELISPOT conversion rate. Therefore, a negative ELISPOT test for M. tuberculosis infection should be interpreted with caution

Hill, PC

Brookes, RH

Fox, A

Jackson-Sillah, D

Jeffries, DJ

Lugos, MD

Donkor, SA

Adetifa, IM

De Jong, BC

Aiken, AM

Adegbola, RA

McAdam, KP

University of Melbourne Institutional Repository

Longitudinal assessment of an ELISPOT test for Mycobacterium tuberculosis infection

Hill, Philip C

Brookes, Roger H

Fox, Annette

Jackson-Sillah, Dolly

Jeffries, David J

Lugos, Moses D

Donkor, Simon A

Adetifa, Ifedayo M

de Jong, Bouke C

Aiken, Alex M

Adegbola, Richard A

McAdam, Keith P

LSHTM Research Online

Crossref

Longitudinal Assessment of an ELISPOT Test for Mycobacterium tuberculosis Infection

BCG and vole bacillus vaccines in the prevention of tuberculosis in adolescents. First (progress) report to the Medical Research Council by their tuberculosis vaccines clinical trials committee.

BCG vaccination: WHO research ofﬁce. Geneva: World Health Organisation.

Comparison of T-cell-based assay with tuberculin skin test for diagnosis of Mycobacterium tuberculosis infection in a school tuberculosis outbreak.

Current laboratory methods for the diagnosis of tuberculosis.

Direct ex vivo analysis of antigen-speciﬁc IFN-gamma-secreting CD4 T cells in Mycobacterium tuberculosis-infected individuals: associations with clinical disease state and effect of treatment.

Dynamic antigen-speciﬁc T-cell responses after point-source exposure to Mycobacterium tuberculosis.

Effect of BCG vaccination on risk of Mycobacterium tuberculosis infection in children with household tuberculosis contact: A prospective community-based study.

Effect of treatment of latent tuberculosis infection on the T cell response to Mycobacterium tuberculosis antigens.

Enzymelinked immunospot assay responses to early secretory antigenic target 6, culture ﬁltrate protein 10, and puriﬁed protein derivative among children with tuberculosis: Implications for diagnosis and monitoring of therapy.

Evaluation of a whole-blood interferon-gamma release assay for the detection of Mycobacterium tuberculosis infection in 2 study populations.

Expression of the mceA, esat-6 and hspX genes in Mycobacterium tuberculosis and their responses to aerobic conditions and to restricted oxygen supply.

Identifying ELISPOT and skin test cut-offs for diagnosis of Mycobacterium tuberculosis infection in The Gambia.

Interpretation of repeated tuberculin tests.

Large-scale evaluation of enzyme-linked immunospot assay and skin test for diagnosis of Mycobacterium tuberculosis infection against a gradient of exposure in The Gambia.

Nonreplicating persistence of Mycobacterium tuberculosis.

On the period of incubation in tuberculosis.

Rapid effector function in CD8þ memory T cells.

Recognition of stage-speciﬁc mycobacterial antigens differentiates between acute and latent infections with Mycobacterium tuberculosis.

Regional differences in HIV trends in The Gambia: Results from sentinel surveillance among pregnant women.

Reliability of tuberculin skin test measurement. Ann Intern Med 126: 210–214. PLoS Medicine | www.plosmedicine.org

Reversion of the ELISPOT test after treatment in Gambian tuberculosis cases.

Serial testing of health care workers for tuberculosis using interferon-gamma assay.

Simultaneous detection and strain differentiation of Mycobacterium tuberculosis for diagnosis and epidemiology.

Strain identiﬁcation of Mycobacterium tuberculosis by DNA ﬁngerprinting: Recommendations for a standardized methodology.

Surveillance of drug-resistant Mycobacterium tuberculosis in The Gambia.

Tuberculin sensitivity: Conversions and reversions in a rural African population.

Tuberculin test conversion during repeated skin testing, associated with sensitivity to nontuberculous mycobacteria.

Tuberculosis studies in Muscogee county, Giorgia: VII. A twenty-year evaluation of BCG vaccination in a school population. Am Rev Respir Dis

Use in routine clinical practice of two commercial blood tests for diagnosis of infection with Mycobacterium tuberculosis: A prospective study.

Use of a T cell-based assay for monitoring efﬁcacy of antituberculosis therapy.

http://minerva-access.unimelb.edu.au/bitstream/11343/260981/1/PMC1891317.pdf

Longitudinal Assessment of an ELISPOT Test for Mycobacterium tuberculosis Infection

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University of Melbourne Institutional Repository

Public Library of Science (PLOS)

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