Effect of tuberculosis-specific antigen stimulation on the diagnostic accuracy of interferon-γ inducible protein-10 in distinguishing active and latent tuberculosis infection: a meta-analysis

Background: Identifying active tuberculosis (ATB) from latent tuberculosis infection (LTBI) persists as a challenge, and interferon-g inducible protein-10 (IP-10) has been employed as the solution. To further improve its diagnostic performance, the sample can be stimulated with TB specific antigen (TBAg). Aim: To perform meta-analysis on diagnostic accuracy of unstimulated and TBAg-stimulated IP-10 in differentiating ATB from LTBI. Methods: Systematic search was performed on five major scientific databases as of 29 November 2023. Observational studies reporting diagnostic values of unstimulated or TBAg-stimulated IP-10 in identifying ATB from LTBI were included. Meta-analysis was carried out using two-level mixed-effect logistic regression model. Results: Twenty-five studies recruiting 2301 patients (1137 ATB versus 1164 LTBI) were included in the quantitative analysis. The pooled sensitivity and specifity of IP-10 were 72% (95%CI: 0.59-0.82) and 78% (95%CI: 0.63-0.88), respectively. As for TBAg-stimulated IP-10, the sensitivity and specifity were 82% (95%CI: 0.76-0.87) and 85% (95%CI: 0.73-0.92), respectively. The senstivity was reduced signiticantly (p < 0.01) when the patients with human immunodeficiency virus infection were included, except after the TBAg stimulation. Conclusion: Stimulating IP-10 with TBAg could improve the diagnostic accuracy in differentiating ATB from LTBI. (c) 2024 Institut Pasteur. Published by Elsevier Masson SAS. All rights are reserved, including those for text and data mining, AI training, and similar technologies.