ArticleAmerican journal of respiratory and critical care medicine2010
Cerebrospinal T-cell responses aid in the diagnosis of tuberculous meningitis in a human immunodeficiency virus- and tuberculosis-endemic population.
Article in American journal of respiratory and critical care medicine, 2010. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 35 papers, 5 of them syntheses that pooled it.
What it found
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
35 citing papers in PubMed, 5 syntheses or guidelines pooled it, 71 citations in OpenAlex.
- Pooled it
- Diagnostic Accuracy of Interferon-Gamma Release Assays for Tuberculous Meningitis: A Systematic Review and Meta-Analysis.Frontiers in cellular and infection microbiology · 2022Pooled it
- Diagnostic Accuracy of T-SPOT.TB Assay for Tuberculous Meningitis: An Updated Meta-Analysis.Frontiers in neurology · 2020Pooled it
- Mortality from HIV-associated meningitis in sub-Saharan Africa: a systematic review and meta-analysis.Journal of the International AIDS Society · 2020Pooled it
- Body Fluid Interferon-γ Release Assay for Diagnosis of Extrapulmonary Tuberculosis in Adults: A Systematic Review and Meta-Analysis.Scientific reports · 2015Pooled it
- Evaluation of targeted sequencing for pathogen identification in bone and joint infections: a cohort study from China.Annals of clinical microbiology and antimicrobials · 2024Article
- A New Scoring System to Differentially Diagnose and Distinguish Tuberculous Meningitis and Bacterial Meningitis in South China.Frontiers in neurology · 2022Article
- Interferon-γ release assays for tuberculous meningitis diagnosis: a meta-analysis.Archives of medical science : AMS · 2021Review
- Challenges in the diagnosis of tuberculous meningitis.Journal of clinical tuberculosis and other mycobacterial diseases · 2020Article
- Overview of Brain-to-Gut Axis Exposed to Chronic CNS Bacterial Infection(s) and a Predictive Urinary Metabolic Profile of a Brain Infected byFrontiers in neuroscience · 2020Review
- The Utility of CSF Xpert MTB/RIF in Diagnosis of Tubercular Meningitis in Children.Indian journal of pediatrics · 2019Observational
- Inadequate diagnostics: the case to move beyond the bacilli for detection of meningitis due to Mycobacterium tuberculosis.Journal of medical microbiology · 2019Article
- A Diagnostic Formula for Discrimination of Tuberculous and Bacterial Meningitis Using Clinical and Laboratory Features.Frontiers in cellular and infection microbiology · 2019Article
- Tuberculous meningitis is associated with higher cerebrospinal HIV-1 viral loads compared to other HIV-1-associated meningitides.PloS one · 2018Article
- Article
- Tuberculosis Meningitis.Current infectious disease reports · 2017Review
- Interferon-Gamma Release Assay Performance of Cerebrospinal Fluid and Peripheral Blood in Tuberculous Meningitis in China.BioMed research international · 2017Article
- The diagnostic value of cerebrospinal fluid chemistry results in childhood tuberculous meningitis.Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery · 2015Article
- Diagnostic Value of T-Cell Interferon-γ Release Assays on Cerebrospinal Fluid for Tuberculous Meningitis.PloS one · 2015Article
- Kinetics of T-cell-based assays on cerebrospinal fluid and peripheral blood mononuclear cells in patients with tuberculous meningitis.The Korean journal of internal medicine · 2014Article
Corrections and comments
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Authors and funding
10 authors at 6 institutions in 3 countries.
Funding
Abstract
rationaleCurrent tools for the rapid diagnosis of tuberculous meningitis (TBM) are suboptimal. We evaluated the clinical utility of a quantitative RD-1 IFN-gamma T-cell enzyme-linked immunospot (ELISPOT) assay (T-SPOT.TB), using cerebrospinal fluid cells for the rapid immunodiagnosis of TBM.
objectivesTo evaluate the diagnostic utility of the RD1 antigen- specific ELISPOT assay for the diagnosis of tuberculous meningitis.
methodsThe ELISPOT assay was evaluated in 150 patients with suspected TBM who were categorized as definite-TBM, probable-TBM, and non-TBM. Culture or polymerase chain reaction positivity for Mycobacerium tuberculosis served as the reference standard. To determine the diagnostic value of the ELISPOT assay, a clinical prediction rule was derived from baseline clinical and laboratory parameters using a multivariable regression model. MEASUREMENTS AND MAIN
resultsA total of 140 patients (81% HIV-infected; median CD4 count, 160 cells/mm(3)) were included in the final analysis. When comparing the definite-TBM (n = 38) and non-TBM groups (n = 48), the ELISPOT assay (cut point of > or =228 spot-forming cells per 1 million mononuclear cells) was a useful rule-in test: sensitivity 58% (95% confidence interval [CI], 41-74); specificity 94% (95% CI, 83-99). However, ELISPOT outcomes improved when other rapid tests were concurrently used to exclude bacterial (Gram stain) and cryptococcal meningitis (latex-agglutination test) within the non-TBM group. Using this approach, the ELISPOT assay (cut point of > or =46 spot-forming cells) was an excellent rule-in test: sensitivity 82% (95% CI, 66-92); specificity 100% (95% CI, 78-100); positive predictive value, 100% (95% CI, 89-100); negative predictive value, 68% (95% CI, 45-86); area under the curve, 0.90. The ELISPOT assay had incremental diagnostic value compared with the clinical prediction rule.
conclusionsThe RD-1 ELISPOT assay, using cerebrospinal fluid mononuclear cells and in conjunction with other rapid confirmatory tests (Gram stain and cryptococcal latex-agglutination test), is an accurate rapid rule-in test for TBM in a TB and HIV endemic setting.
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