ABSTRACT
SETTING: The diagnostic utility of serodiagnosis of tuberculosis in HIV-infected persons was studied in Kampala, Uganda. OBJECTIVE: This study was undertaken to evaluate the utility of a recently described serologic assay for the diagnosis of tuberculosis in HIV-infected patients. DESIGN: The study was undertaken as a cross-sectional survey of 349 subjects, including human immunodeficiency virus-infected and uninfected patients with tuberculosis and control subjects. Serum from each subject was assayed by enzyme-linked immunosorbent assay (ELISA) for IgG antibody to the 30,000 dalton antigen of Mycobacterium tuberculosis. RESULTS: Test sensitivity dropped from 0.62 in non HIV-infected tuberculous patients to 0.28 in HIV-infected patients. CONCLUSIONS: ELISA serodiagnosis of tuberculosis may have a markedly decreased utility in populations where HIV infection is prevalent.
Subject(s)
AIDS-Related Opportunistic Infections/diagnosis , Tuberculosis/diagnosis , Antibodies, Bacterial/blood , Cross-Sectional Studies , Enzyme-Linked Immunosorbent Assay/methods , Humans , Immunoglobulin G/blood , Mycobacterium tuberculosis/immunology , Predictive Value of Tests , Sensitivity and Specificity , Serologic TestsABSTRACT
A 22,500-Da antigen apparently specific to Mycobacterium avium, Mycobacterium intracellulare, and Mycobacterium scrofulaceum has been identified by Western immunoblotting. By use of a dot immunoassay, this antigen was found in the urine of 64% of patients with AIDS and disseminated M. avium disease. It was not found in the urine of healthy control subjects. Detection of antigenuria might provide the basis for rapid diagnosis of M. avium disease in patients with AIDS.
Subject(s)
Acquired Immunodeficiency Syndrome/complications , Antigens, Bacterial/urine , Mycobacterium Infections/immunology , Mycobacterium avium/immunology , Acquired Immunodeficiency Syndrome/immunology , Acquired Immunodeficiency Syndrome/urine , Animals , Antibodies, Bacterial/biosynthesis , Antibodies, Bacterial/immunology , Antigens, Bacterial/immunology , Blotting, Western , Goats , Humans , Mycobacterium/immunology , Mycobacterium Infections/complicationsABSTRACT
A simple dot enzyme immunoassay based on the recognition of serum IgG antibody to a 30,000 dalton native antigen purified from culture filtrates of Mycobacterium tuberculosis was developed and compared with a standard plate enzyme-linked immunosorbent assay in the serodiagnosis of tuberculosis. The previously described favorable test characteristics of plate enzyme-linked immunoassay were confirmed; although the dot enzyme immunoassay was promising, it was less satisfactory. Dot enzyme immunoassay may have its most promising use as a screening test for situations of limited technical facilities. Both plate enzyme-linked immunoassay and dot enzyme immunoassay had markedly reduced sensitivities in persons with human immunodeficiency virus infection.
