Value of blood interferon-γ release assay in early adjuvant diagnosis of tuberculous meningitis

Abstract:

ObjectiveTo evaluate the value of peripheral blood Mycobacterium tuberculosis interferonγ release assay（TBIGRA ）in early adjuvant diagnosis of  tuberculous meningitis(TBM).  Methods56 patients with TBM (trial group) and 56 patients with nonTB meningitis (control group) admitted to West China Hospital of Sichuan University in JanuaryDecember 2015 were analyzed, results of TBIGRA, cerebrospinal fluid(CSF) Mycobacterium tuberculosis(MT) culture, and CSF TBDNA testing of two groups of patients were analyzed, the sensitivity and specificity of each diagnostic method were calculated. ResultsThe sensitivity of TBIGRA, CSF MT culture, and CSF TBDNA for diagnosis of TBM were 87.5%（49/56）, 19.6%（11/56）, and 60.7%（34/56） respectively，specificity were 89.3%（50/56）, 100.0%（56/56）, and 76.8%（43/56）respectively. The sensitivity of TBIGRA for diagnosing TBM was higher than that of CSF TBDNA and CSF MT culture, specificity of TBIGRA was higher than that of CSF TBDNA(89.3%>76.8%), pairwise comparison showed a significant difference(all P<0.01). Among 11 cases confirmed by CSF culture, 10 (90.9%［10/11］）were positive for TBIGRA; among 45 cases with clinical diagnosis and effective antituberculosis treatment, 39 (86.7%［39/45］）were positive for TBIGRA. ConclusionTBIGRA is highly sensitive and specific in the early adjuvant diagnosis of TBM, it is convenient, rapid, effective, and worthy to be popularized in clinical practice.