New TB test reveals patients at risk, says study

October 20, 2008

A recently introduced blood test can reveal which patients may develop active tuberculosis (TB) much more precisely than the 100-year old TB skin test, according to a new study published today in the journal Annals of Internal Medicine.

Around a third of the world's population is infected with the TB bacteria and approximately 9 million new cases of active TB are diagnosed around the world each year, according to World Health Organisation estimates. The majority of those infected live in the developing world.

The new ELISpot blood test is able to identify patients with a significant risk of developing the active form of TB, according to the study, carried out by researchers from Imperial College London working with international colleagues.

Patients with active TB experience the symptoms of the disease, which include fever, persistent cough, and loss of appetite, whereas patients with the dormant, 'latent' form of TB do not. Treatment can prevent many patients with latent TB from progressing to active TB.

The researchers believe that the ELISpot blood test can enable preventative treatment to be targeted in a more focused way than the tuberculin skin test. Unlike the blood test, the skin test commonly gives falsely positive results if a patient has previously been vaccinated against TB.

The blood test will allow doctors to identify and treat those who need preventative treatment whilst reducing the numbers treated unnecessarily, thus avoiding the attendant risks of drug side-effects, according to the researchers. This is especially important in the developing world where there are limited resources for both testing and treatment.

Today's research looked at 908 children in Istanbul, Turkey, who had recently been exposed to TB in their household. Of these, 594 tested positive for latent TB using the ELISpot blood test, the skin test, or both.

Of 550 children who tested positive for TB with the skin test, 12 went on to develop active TB. Fewer children tested positive for TB with the blood test (381), but the test still picked up 11 of the 12 children who went on to develop active TB.

Children with a positive ELISpot blood test result had approximately a four-fold higher risk of developing TB disease than children with a negative result. A higher proportion of children with a positive ELISpot blood test result developed TB disease compared to children with a positive TB skin test.

As a precautionary measure, 76% of the children in the study had been given prophylactic treatment to prevent them from developing active TB. This meant that the researchers could not determine the proportion of children who would have gone on to develop active disease had they remained untreated. Nonetheless, the study identified a significant risk for children with a positive ELISpot blood test result of developing active TB, despite the majority having received treatment, and this risk is therefore an underestimate of the risk in untreated children.

Professor Ajit Lalvani, the lead author of the study and a Wellcome Trust Senior Clinical Research Fellow at the Centre for Respiratory Infection at Imperial College London, said: "A lot of people in places like the UK think of TB as being an old disease that we no longer need to worry about, but even in this country the numbers of cases have been rising for almost 20 years. Outside the developed world, TB has reached pandemic proportions and still causes an immense amount of suffering and death.

"Our study shows that new tools like the blood test can help tackle the global pandemic. We now know that the blood test really helps to target treatment to those who most need it in order to prevent them from developing active TB. Building on this work, we are now validating a next generation of tests that have been developed by our TB Task Force at Imperial," added Professor Lalvani.

The ELISpot test, which was created by Professor Lalvani and colleagues, works by detecting a protein signal, known as interferon-gamma, released by white blood cells of the immune system in response to TB infection. The test has been recommended for use alongside the skin test in around 20 countries worldwide, including the EU and North America.

Source: Imperial College London

Explore further: Smartphone case offers blood glucose monitoring on the go

Related Stories

Smartphone case offers blood glucose monitoring on the go

December 7, 2017
Engineers at the University of California San Diego have developed a smartphone case and app that could make it easier for patients to record and track their blood glucose readings, whether they're at home or on the go.

New compound stops progressive kidney disease in its tracks

December 7, 2017
Progressive kidney diseases, whether caused by obesity, hypertension, diabetes, or rare genetic mutations, often have the same outcome: The cells responsible for filtering the blood are destroyed. Reporting today in Science, ...

In multiple myeloma, high levels of enzyme ADAR1 are associated with reduced survival

December 5, 2017
Multiple myeloma is the second most common blood cancer in the United States. Thirty to 50 percent of multiple myeloma patients have extra copies of the gene that encodes the enzyme ADAR1. Using a database of multiple myeloma ...

Researchers connect severity of 'kissing disease' to T-cell population

December 5, 2017
Acute infectious mononucleosis (AIM), also known as mono or the "kissing disease," is caused by the Epstein-Barr Virus (EBV). In a paper published this week in mBio, researchers connect the onset and severity of mono to T-cells ...

New immunotherapy targets misshapen protein in rare childhood brain cancer

December 4, 2017
Children with an extremely deadly form of brain cancer might benefit from a new treatment that aims to direct an immune response against an abnormally shaped protein found exclusively on cancer cells, according to a new study ...

Thyroid hormone therapy heals lung fibrosis in animal study

December 4, 2017
Thyroid hormone therapy significantly resolves fibrosis, or scarring, in the lungs of mice, increasing their survival from disease, a Yale-led study shows. These provide a novel insight into the development of pulmonary fibrosis ...

Recommended for you

Protein Daple coordinates single-cell and organ-wide directionality in the inner ear

December 11, 2017
Humans inherited the capacity to hear sounds thanks to structures that evolved millions of years ago. Sensory "hair cells" in the inner ear have the amazing ability to convert sound waves into electrical signals and transmit ...

Team identifies DNA element that may cause rare movement disorder

December 11, 2017
A team of Massachusetts General Hospital (MGH) researchers has identified a specific genetic change that may be the cause of a rare but severe neurological disorder called X-linked dystonia parkinsonism (XDP). Occurring only ...

Gene therapy improves immunity in babies with 'bubble boy' disease

December 9, 2017
Early evidence suggests that gene therapy developed at St. Jude Children's Research Hospital will lead to broad protection for infants with the devastating immune disorder X-linked severe combined immunodeficiency disorder. ...

In lab research, scientists slow progression of a fatal form of muscular dystrophy

December 8, 2017
In a paper published in the Nature journal Scientific Reports, Saint Louis University (SLU) researchers report that a new drug reduces fibrosis (scarring) and prevents loss of muscle function in an animal model of Duchenne ...

Double-blind study shows HIV vaccine not effective in viral suppression

December 7, 2017
(Medical Xpress)—A large team of researchers from the U.S. and Canada has conducted a randomized double-blind study of the effectiveness of an HIV vaccine and has found it to be ineffective in suppressing the virus. In ...

Time matters: Does our biological clock keep cancer at bay?

December 7, 2017
Our body has an internal biological or "circadian" clock, which cycles daily and is synchronized with solar time. New research done in mice suggests that it can help suppress cancer. The study, publishing 7 December in the ...

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.