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EARLY TUBERCULOSIS IMMUNODETECTION USING GENOMIC ANTIGENS AND INDUCEMENT OF T-CELLS IN HIV+TB SUBJECTS IN LAGOS, NIGERIA
ABSTRACT
Immune-compromised individuals, such as HIV/AIDS patients, are more likely to develop tuberculosis (TB) sickness. Sputum smear microscopy, culture, and chest X-rays are some of the traditional TB diagnosis techniques, however they have downsides and known limits. When an individual has weakened immunity, the restrictions are more obvious. The consequences of inadequate TB diagnosis, particularly in environments with limited resources like Nigeria, contribute to the disease’s increased incidence. The development of immunodetection techniques utilizing genetic antigens is preparing for TB early detection. The goal of this study was to assess the genomic TB antigens accessible for T-cell stimulation and to investigate if stimulating T cells could enhance diagnostic performance in immunocompromised patients. Subjects with only active TB, HIV+TB, HIV only, subjects with contacts who have TB, and apparently healthy subjects make up the study population. Controls Sputum samples were taken, and they were subjected to culture and smear microscopy. Whole blood cells from individuals and contacts suspected of having TB were incubated with RPMI 1640, glutamine, and fetal calf serum (FCS) to induce T-cells during incubation and provide an enriched medium of protein and vitamins for the blood’s T-cells. This improved the T-cells’ ability to respond when stimulated during incubation. The whole blood was stimulated with a low dose of 2.5 g/ml of TB antigens (ESAT-6,CFP-10, and ELLI the novel TB antigen) acquired from LIONEX Inc. Germany during the 72-hour incubation. To measure the IFN- produced following T-cell stimulation, the Interferon Gamma Release Assay (IGRA) was performed on sera collected after stimulation. a smear microscopy finding & culture showed that some of the positive results from the smear microscopy were found to be negative for the culture, even though a significant percentage of positivity was acquired from the results. These were some of the low specificity and high sensitivity problems that were found. When comparing the new ELLI antigen to the older ESAT-6 and CFP-10, the results of employing TB antigens for T-cell activation revealed that ELLI was the most immunogenic of the antigens utilized. T-cells functioned best when they were activated with low doses of the ELLI antigen and the combination ESAT-6+CFP-10. Induced T-cells helped diagnose TB in HIV participants who were asymptomatic for the disease and people at risk, particularly those who had previously been in contact with someone who had the disease. IGRA’s sensitivity and specificity increased by more than 80% after T-cell induction. Finally, the study compares the accuracy of utilizing genomic antigens for TB diagnosis to that of using non-genomic antigens. This strategy may enhance the immunodetection technique’s ability to detect TB subjects.
