الفهرس | Only 14 pages are availabe for public view |
Abstract Background: Early diagnosis and treatment are important in prevention of TB infection. Recently Quantiferon-TB Gold In Tube test (QFT-GIT) assay has been avilable for diagnosis of pulmonary TB.We assess QFT-GIT assay in the diagnosis of pulmonary TB with special concern on the role of QFT-GIT and the percentage of γ9/δ2 T cells as tools to monitor the efficacy of anti-tuberculosis treatment and the correlation between them and clinical, and radiological findings. Aim: In our study we aimed to evaluate the diagnostic potential of QFT-GIT assay for diagnosis of active pulmonary TB, measure the percentage of γ9/δ2 T cells in the peripheral blood of patients with pulmonary TB, assess the levels of IFN-γ and the percentage of γ9/δ2 T cells in patients with pulmonary TB as tools to monitor the efficacy of anti-tuberculosis treatment and correlate between the levels of IFN-γ and percentage of γ9/δ2 T cells in the patients with the clinical and radiological findings. Methods: Pulmonary TB patients and healthy control persons in our study were evaluated by TST, QFT-GIT assay, and γ9/δ2 T cells by flowcytometry. QFT-GIT assay, and γ9/δ2 T cells by flowcytometry were done twice for the pulmonary TB patients, first at the start of treatment and second after 3months of treatment Results: Sputum smears for acid fast bacilli (AFB) were positive only in (77.5%) of patients. The specificity and sensitivity of the QFT-GIT assay were 92.5% and 93.5% respectively higher than those of TST, which were 82.5% and 40% respectively. For the 27 pulmonary TB patients with improvements QFT-GIT at the start of treatment was 1.58 IU/ml and declined to 0.7 IU/ml after 3 months of treatment with statistically significant P-value. Also, the mean γ9/δ2 T cells % At the start of treatment was 1.26 % and declined after 3 months of treatment to 1.06 %. Also, in our study, the mean γ9/δ2 T cells % in pulmonary TB patients with improvements was 1.31% and declined to 1.01% but with no statistically significant P-value in correlation to improvement. The mean γ9/δ2 T cells % in pulmonary TB patients at the start of treatment was higher in stage 1 (1.57%) and stage 2 (1.37%) than in stage 3 (0.36%). Conclusion: QFT-GIT assay could function as a powerful immunodiagnostic test to explore pulmonary TB and to predict the efficacy of antituberculosis treatment after 3 months of treatment in cases of pulmonary TB while, γ9/δ2 T cells % cannot be used to monitor the efficacy of antituberculosis treatment in but it declined with advanced stage (stage III) of pulmonary TB in compare to stage I and II. |