Acute phase proteins and IP-10 as triage tests for the diagnosis of tuberculosis: systematic review and meta-analysis
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SANTOS, Victor Santana, GOLETTI, Delia, NOI, Autori, KRUDU, V.. Acute phase proteins and IP-10 as triage tests for the diagnosis of tuberculosis: systematic review and meta-analysis. In: Clinical Microbiology and Infection, 2019, nr. 2(25), pp. 169-177. ISSN 1198-743X. DOI: https://doi.org/10.1016/j.cmi.2018.07.017
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Clinical Microbiology and Infection
Numărul 2(25) / 2019 / ISSN 1198-743X /ISSNe 1469-0691

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

DOI:https://doi.org/10.1016/j.cmi.2018.07.017

Pag. 169-177

Santos Victor Santana1, Goletti Delia2, Noi Autori, Krudu V.3
 
1 Federal University of Alagoas, Arapiraca,
2 „L. Spallanzani" National Institute for Infectious Diseases (INMI), Rome,
3 Institute of Phtysiopneumology „Chiril Draganiuc”
 
 
Disponibil în IBN: 28 aprilie 2021


Rezumat

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. 

Cuvinte-cheie
acute phase proteins, IP-10screening, systematic review, tuberculosis