We found a match
Your institution may have rights to this item. Sign in to continue.
- Title
The Ability of a 3-Gene Host Signature in Blood to Distinguish Tuberculous Meningitis From Other Brain Infections.
- Authors
Huynh, Julie; Nhat, Le Hoang Thanh; Bao, Nguyen Le Hoai; Hai, Hoang Thanh; Thu, Do Dang Anh; Tram, Trinh Thi Bich; Dung, Vu Thi Mong; Vinh, Do Dinh; Ngoc, Nghiem My; Donovan, Joseph; Phu, Nguyen Hoan; Thanh, Dang Van; Thu, Nguyen Thi Anh; Bang, Nguyen Duc; Ha, Dang Thi Minh; Nghia, Ho Dang Trung; Tan, Le Van; Van, Le Hong; Thwaites, Guy; Thuong, Nguyen Thuy Thuong
- Abstract
Background Tuberculous meningitis (TBM) is difficult to diagnose. We investigated whether a 3-gene host response signature in blood can distinguish TBM from other brain infections. Methods The expression of 3 genes (dual specificity phosphatase 3 [ DUSP3 ], guanylate-binding protein [ GBP5 ], krupple-like factor 2 [ KLF2 ]) was analyzed by RNA sequencing of archived whole blood from 4 cohorts of Vietnamese adults: 281 with TBM, 279 with pulmonary tuberculosis, 50 with other brain infections, and 30 healthy controls. Tuberculosis scores (combined 3-gene expression) were calculated following published methodology and discriminatory performance compared using area under a receiver operator characteristic curve (AUC). Results GBP5 was upregulated in TBM compared to other brain infections (P <.001), with no difference in DUSP3 and KLF2 expression. The diagnostic performance of GBP5 alone (AUC, 0.74; 95% confidence interval [CI],.67–.81) was slightly better than the 3-gene tuberculosis score (AUC, 0.66; 95% CI,.58–.73) in TBM. Both GBP5 expression and tuberculosis score were higher in participants with human immunodeficiency virus (HIV; P <.001), with good diagnostic performance of GBP5 alone (AUC, 0.86; 95% CI,.80–.93). Conclusions The 3-gene host signature in whole blood has the ability to discriminate TBM from other brain infections, including in individuals with HIV. Validation in large prospective diagnostic study is now required.
- Subjects
TUBERCULOUS meningitis; VIETNAMESE people; HIV; GENE expression; TUBERCULOSIS
- Publication
Journal of Infectious Diseases, 2024, Vol 230, Issue 2, pe268
- ISSN
0022-1899
- Publication type
Article
- DOI
10.1093/infdis/jiad606