{"doi":"10.1371/journal.pone.0234130","title":"Evaluation of multi-antigen serological screening for active tuberculosis among people living with HIV","abstract":"Better triage tests for screening tuberculosis (TB) disease are needed for people living with HIV (PLHIV). We performed the first evaluation of a previously-validated 8-antigen serological panel to screen PLHIV for pulmonary TB in Kampala, Uganda. We selected a random 1:1 sample with and without TB (defined by sputum culture) from a cohort of PLHIV initiating antiretroviral therapy. We used a multiplex microbead immunoassay and an ensemble machine learning classifier to determine the area under the receiver operating characteristic curve (AUC) for Ag85A, Ag85B, Ag85C, Rv0934-P38, Rv3881, Rv3841-BfrB, Rv3873, and Rv2878c. We then assessed the performance with the addition of four TB-specific antigens ESAT-6, CFP-10, Rv1980-MPT64, and Rv2031-HSPX, and every antigen combination. Of 262 participants (median CD4 cell-count 152 cells/μL [IQR 65-279]), 138 (53%) had culture-confirmed TB. The 8-antigen panel had an AUC of 0.53 (95% CI 0.40-0.66), and the additional 4 antigens did not improve performance (AUC 0.51, 95% CI 0.39-0.64). When sensitivity was restricted to ≥90% for the 8- and 12-antigen panel, specificity was 2.2% (95% CI 0-17.7%) and 8.1% (95% CI 0-23.9%), respectively. A three-antigen combination (Rv0934-P38, Ag85A, and Rv2031-HSPX) outperformed both panels, with an AUC of 0.60 (95% CI 0.48-0.73), 90% sensitivity (95% CI 78.2-96.7%) and 29.7% specificity (95% CI 15.9-47%). The multi-antigen panels did not achieve the target accuracy for a TB triage test among PLHIV. We identified a new combination that improved performance for TB screening in an HIV-positive sample compared to an existing serological panel in Uganda, and suggests an approach to identify novel antigen combinations specifically for screening TB in PLHIV.","journal":"PLoS ONE","year":2020,"id":71558,"datarank":0.4335557636844247,"base_score":2.8903717578961645,"endowment":2.8903717578961645,"self_citation_contribution":0.4335557636844247,"citation_network_contribution":0.0,"self_endowment_contribution":0.4335557636844247,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":17,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9512,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2020-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":286886,"name":"Jayant V. Rajan","orcid":null,"position":1,"is_corresponding":false},{"id":378253,"name":"Christina Yoon","orcid":"0000-0003-0865-4108","position":2,"is_corresponding":false},{"id":378254,"name":"Resmi Ravindran","orcid":"0000-0002-3532-0261","position":3,"is_corresponding":false},{"id":378255,"name":"Alfred Andama","orcid":"0000-0003-0526-0007","position":4,"is_corresponding":false},{"id":378256,"name":"Lucy Asege","orcid":"0000-0002-6591-3180","position":5,"is_corresponding":false},{"id":378257,"name":"Sandra Mwebe","orcid":"0000-0003-0184-3598","position":6,"is_corresponding":false},{"id":379680,"name":"Jane Katende","orcid":null,"position":7,"is_corresponding":false},{"id":379681,"name":"Martha Nakaye","orcid":null,"position":8,"is_corresponding":false},{"id":328477,"name":"Fred C. Semitala","orcid":"0000-0002-0624-7640","position":9,"is_corresponding":false},{"id":251121,"name":"Imran Khan","orcid":"0000-0001-6888-7347","position":10,"is_corresponding":false},{"id":315466,"name":"Adithya Cattamanchi","orcid":"0000-0002-6553-2601","position":11,"is_corresponding":false},{"id":378252,"name":"Devan Jaganath","orcid":"0000-0002-8555-5667","position":0,"is_corresponding":true}],"reference_count":44,"raw_metadata":{"citation_network_status":"fetched"},"created_at":"2026-07-18T21:44:25.469842Z","pmid":"32497095","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}