AUTHOR=Wen An , Leng Er-Ling , Liu Shi-Min , Zhou Yong-Liang , Cao Wen-Feng , Yao Dong-Yuan , Hu Fan 

TITLE=Diagnostic Accuracy of Interferon-Gamma Release Assays for Tuberculous Meningitis: A Systematic Review and Meta-Analysis

JOURNAL=Frontiers in Cellular and Infection Microbiology

VOLUME=Volume 12 - 2022

YEAR=2022

URL=https://www.frontiersin.org/journals/cellular-and-infection-microbiology/articles/10.3389/fcimb.2022.788692

DOI=10.3389/fcimb.2022.788692

ISSN=2235-2988

ABSTRACT=Aims:To evaluate and compare diagnostic accuracy of blood and cerebrospinal fluid interferon-gamma release assays (IGRAs) for diagnosing tuberculous meningitis (TBM), and review relevant literature.Main methods:We searched several databases including Medline,Embase,Cochrane databases and Chinese databases to identify studies published before 2021. All studies with QuantiFERON-TB Gold In-Tube and/or T-SPOT.TB (ELISPOT) assays of blood and/or cerebrospinal fluid (CSF), which complied with the Guidelines for the Quality Assessment of Diagnostic Accuracy Studies, were included.Quality of the included studies was assessed by using the revised Quality Assessment for Studies of Diagnostic Accuracy (QUADAS-2) method.Begg’s funnel plots were used to evaluate  publication biasin the meta-analysis of diagnostic studies and statistical analysis was performed by using Stata (Version 12) software.Key findings:Twelve studies with  blood and/or CSF IGRAs including 376 samples in patient group and 493 in the control group were included. The sensitivity, specificity, positive likelihood ratio (PLR), negative likelihood ratio (NLR), diagnostic odds ratio (DOR), and area under summary receiver operating characteristic curve (SROC)of the blood IGRAs in the pooled data from 12 studies were 74% (95% CI: 0.65-0.82), 78% (95% CI: 0.68-0.86), 3.38 (95% CI 2.26-5.06), 0.33 (95% CI: 0.23-0.46), 10.25 (95% CI: 5.46-19.25), and 0.83 (95% CI: 0.79-0.86), respectively. For cerebrospinal fluid IGRAs, these values for the pooled data from the 10 studies included were 79% (95% CI: 0.71-0.85), 95% (95% CI: 0.88-0.98), 16.30 (95% CI 6.5-40.83), 0.22 (95% CI: 0.16-0.31), 57.93 (95% CI: 22.56-148.78),and 0.91 (95% CI: 0.88-0.93), respectively.Significance: Cerebrospinal fluid IGRAs exhibited a better diagnostic accuracy than blood IGRAs in diagnosing TBM.