ANALYSIS OF THE IMMUNOLOGICAL HUMORAL RESPONSE TO MYCOBACTERIUM-TUBERCULOSIS GLYCOLIPID ANTIGENS (DAT, PGLTB1) FOR DIAGNOSIS OF TUBERCULOSIS IN HIV-SEROPOSITIVE AND HIV-SERONEGATIVE PATIENTS

Using an enzyme immunoassay (EIA) test, the concentrations of IgG anti bodies against 2,3 diacyl trehalose (DAT) and phenolic glycolipid Tb1 (PGLTb1) were measured in the sera of 153 patients with active tubercu losis, 50 of whom were coinfected with HIV, and in the sera of 152 hea lthy blood donors, 149 asymptomatic HIV-seropositive patients, 12 HIV- seronegative patients with conditions simulating tuberculosis, 23 HIV- seropositive patients with disseminated infection caused by mycobacter ia other than tuberculosis and 24 HIV-seropositive patients with pulmo nary disease from whom mycobacteria was not isolated in culture. A sli ghtly lower percentage (74 %) of the HIV-seropositive than the HIV-ser onegative (77 %) tuberculosis patients were positive for anti-DAT and anti-PGLTb1 IgG antibodies, with a specificity ranging from 91 to 95 % . There was no significant difference between EIA sensitivity in smear -positive and smear-negative patients with pulmonary tuberculosis for all HIV immune statuses and sites of disease (pulmonary vs. extrapulmo nary). In HIV-seropositive patients, however, sensitivity was always l ower for disseminated tuberculosis than for localized tuberculosis, Co mbining data for both the smear test and the EIA maximized sensitivity , The main value of the EIA test could be to provide early complementa ry information by antibody detection in patients with tuberculosis, pa rticularly those with a negative smear test.