The Role of Chemokine Family, CXCL-10 Urine as a Marker Diagnosis of Active Lung Tuberculosis in HIV/AIDS Patients
Human Immunodeficiency Virus (HIV) pandemic increased significantly worldwide. The rise in cases of HIV/AIDS was also followed by an increase in the incidence of opportunistic infection, with tuberculosis being the most opportunistic infection found in HIV/AIDS and the main cause of mortality in HIV/AIDS patients. Diagnosis of tuberculosis in HIV/AIDS patients is often difficult because of the uncommon symptom in HIV/AIDS patients compared to those without the disease. Thus, diagnostic tools are required that are more effective and efficient to diagnose tuberculosis in HIV/AIDS. CXCL-10/IP-10 is a chemokine that binds to the CXCR3 receptor found in HIV/AIDS patients with a weakened immune system. Tuberculosis infection in HIV/AIDS activates chemokine IP-10 in urine, which is used as a marker for diagnosis of infection. The aim of this study was to prove whether IP-10 urine can be a biomarker diagnosis of active lung tuberculosis in HIV-AIDS patients. Design of this study is a cross sectional study involving HIV/AIDS patients with lung tuberculosis as the subject of this study. Forty-seven HIV/AIDS patients with tuberculosis based on clinical and biochemical laboratory were asked to collect urine samples and IP-10/CXCL-10 urine being measured using ELISA method with 18 healthy human urine samples as control. Forty-seven patients diagnosed as HIV/AIDS were included as a subject of this study. HIV/AIDS were more common in male than in women with the percentage in male 85.1% vs. 14.5% of women. In this study, most diagnosed patients were aged 31-40 years old, followed by those 21-30 years, and > 40 years old, with one case diagnosed at age less than 20 years of age. From the result of the urine IP-10 using ELISA method, there was significant increase of the mean value of IP-10 urine in patients with TB-HIV/AIDS co-infection compared to the healthy control with mean 61.05 pg/mL ± 78.01 pg/mL vs. mean 17.2 pg/mL. Based on this research, there was significant increase of urine IP-10/CXCL-10 in active lung tuberculosis with HIV/AIDS compared to the healthy control. From this finding, it is necessary to conduct further research into whether urine IP-10/CXCL-10 plays a significant role in TB-HIV/AIDS co-infection, which can also be used as a biomarker in the early diagnosis of TB-HIV.
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 Cahyadi E. Hubungan Stadium Klinis dengan Jumlah CD4 Penderita HIV di BLUD RSUZA Banda Aceh. 2014.
 Cannas A, Calvo L, Chiacchio T, Cuzzi G, Vanini V, et al. IP10 detection in urine is associated with lung diseases. BMC Infectious Diseases 2010;10(333):1-8.
 Contreas G, Donnachie E, Murphy JR, Heresy GP. Elevated IP10 associates with CD8 cell activation and low CD4 in perinatally acquired HIV infection. OFID. 2014;1(1):S427.
 Directorate General of Communicable Disease Control and Environmental Health of Ministry of Health Indonesia. Statistical Report Case of HIV-AIDS in Indonesia. 2014.
 Directorate General of Communicable Disease Control and Environmental Health of Ministry of Health Indonesia. Technical Guidelines for Clinical Management of TB-HIV Co-infection. 2012.
 WHO. Global Tuberculosis Report 2012.
 Gopalan N, Chandrasekaran P, Swaminathan S, Tripathy S. Current trends and intricacies in the management of HIV-associated pulmonary tuberculosis. AIDS Res Ther. 2016;13(34):1-19.
 Hong JY, Lee HJ, Kim SY, Chung KS, Kim EY, et al. Efficacy of IP10 as a biomarker for monitoring tuberculosis treatment. J Infect. 2014;68(3):252-8.
 Latorre I, Diaz J, Mialdea I, Serra-Vidal M, Altet N, et al. IP10 is an accurate biomarker for the diagnosis of tuberculosis in children. J Infect. 2014;69(6):590-9.
 Murray C, Ortoblad K, Guinovart C, Lim S, Wolock T, et al. Global, regional, and national incidence and mortality for HIV, tuberculosis, and malaria during 1990-2013: a systematic analysis for the Global Burden of Disease Study 2013. Lancet. 2014;384(9947):1005-1070.
 Peter J, Green C, Hoelscher M, Mwaba P, Zumla A, et al. Urine for the diagnosis of tuberculosis: current approaches, clinical applicability and new developments. Curr Opin Pulm Med. 2010;16(3):262-70.
 Ruhwald M, Aabye MG, Ravn P. IP10 release assays in the diagnosis of tuberculosis infection: current status and future directions. Expert Rev Mol Diagn. 2012;12(2):175-87.
 Petrone L, Cannas A, Aloi F, Nsubuga M, Sserumkuma J et al. Blood or urine IP10 cannot discriminate between active tuberculosis and respiratory diseases different from children. Biomed Research International. 2015;1-11.
 Wergeland I, Pullar N, Assmus J, Ueland T, Tonby K, et al. IP10 differentiates between active and latent tuberculosis irrespective of HIV status and declines during therapy. J Infect. 2015;70(4):381-91.