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Title: | Acute phase proteins and IP-10 as triage tests for the diagnosis of tuberculosis: systematic review and meta-analysis |
Author: | Santos, Victor S. Goletti, Delia Kontogianni, Konstantina Adams, Emily R. Molina Moya, Barbara Domínguez Benítez, José Crudu, Valeriu Martins-Filho, Paulo R.S. Ruhwald, Morten Lawson, Lovett Bimba, John S. García-Basteiro, Alberto L. Petrone, Linda Kabeer, Basir S. Reither, Klaus Cuevas, Luis E. |
Keywords: | Tuberculosi Diagnòstic Tuberculosis Diagnosis |
Issue Date: | Feb-2019 |
Publisher: | Elsevier |
Abstract: | 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 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. Results: 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. 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. |
Note: | Versió postprint del document publicat a: http://dx.doi.org/10.1016/j.cmi.2018.07.017 |
It is part of: | Clinical Microbiology and Infection, 2019, vol. 25, num. 2, p. 169–177 |
URI: | http://hdl.handle.net/2445/128323 |
Related resource: | http://dx.doi.org/ 10.1016/j.cmi.2018.07.017 |
ISSN: | 1198-743X |
Appears in Collections: | Articles publicats en revistes (ISGlobal) |
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File | Description | Size | Format | |
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Santos_VS_Clin_Microbiol_Infect_2018.pdf | 1.24 MB | Adobe PDF | View/Open |
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