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SYSTEMATIC REVIEW article

Front. Microbiol.
Sec. Infectious Agents and Disease
Volume 15 - 2024 | doi: 10.3389/fmicb.2024.1506127

Diagnostic performance of biomarkers for differentiating active tuberculosis from latent tuberculosis: A systematic review and Bayesian network meta-analysis

Provisionally accepted
Ji Hun Jeong Ji Hun Jeong 1SUNGRYUL SHIM SUNGRYUL SHIM 2,3Sangah Han Sangah Han 4*Inhwan Hwang Inhwan Hwang 5*Chunhwa Ihm Chunhwa Ihm 1*
  • 1 Department of Laboratory medicine, Daejeon Eulji Medical Center, Eulji University, Daejeon, Republic of Korea, Daejeon, Republic of Korea
  • 2 Department of Biomedical Informatics, College of Medicine, Konyang University, Daejeon, Republic of Korea
  • 3 Konyang Medical Data Research groupKYMERA, Konyang University Hospital, Daejeon, Republic of Korea
  • 4 Department of Blood Management Services, Daejeon Eulji Medical Center, Eulji University, Daejeon, Republic of Korea
  • 5 Department of Hematooncology, Daejeon Eulji Medical Center, Eulji University, Daejeon, Republic of Korea

The final, formatted version of the article will be published soon.

    Background: PCR and culture tests are used together to confirm the diagnosis of active tuberculosis (TB). Due to the long culture period, if the PCR test is negative, it takes a significant amount of time for the culture result to be available. Interferon-γ release assays (IGRAs), which are widely used to diagnose TB or latent tuberculosis infection (LTBI), cannot effectively discriminate TB from LTBI. The purpose of this study is to analyze the diagnostic performance of various markers for differentiating between TB from LTBI.Methods: PubMed-Medline, EMBASE, Cochrane Library, and Web of Science were searched up to the end of May 2024, without restrictions on publication date and population. Articles describing the diagnostic value of at least one biomarker for differentiating between TB and LTBI were included. The QUADAS-2 tool was used to assess study quality. Two independent researchers assessed the articles using Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The network meta-analysis (NMA) was performed for diagnostic tools of 11 groups used to differentiate TB from LTBI.Results: Out of 164 identified articles, 159 reports were included in the systematic review and 58 in the meta-analysis. Seventy results from 58 reports accounting for 9,291 participants were included. When measuring interleukin-2 (IL-2) after stimulation with latency antigen, the most significant odds ratio was shown in terms of sensitivity, specificity, positive predictive value and negative predictive value. The values were 9. 46, 18.5, 11.30, and 9.61, respectively.This study shows that the IL-2 level after stimulation with latent antigen is a potential biomarker for differentiating TB from LTBI.

    Keywords: Tuberculosis, Latent Tuberculosis, biomarkers, differential diagnosis, interleukin-2 (IL-2)

    Received: 09 Oct 2024; Accepted: 03 Dec 2024.

    Copyright: © 2024 Jeong, SHIM, Han, Hwang and Ihm. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence:
    Sangah Han, Department of Blood Management Services, Daejeon Eulji Medical Center, Eulji University, Daejeon, Republic of Korea
    Inhwan Hwang, Department of Hematooncology, Daejeon Eulji Medical Center, Eulji University, Daejeon, Republic of Korea
    Chunhwa Ihm, Department of Laboratory medicine, Daejeon Eulji Medical Center, Eulji University, Daejeon, Republic of Korea, Daejeon, Republic of Korea

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.