Evaluation of lipoarabinomannan for the serological diagnosis of tuberculosis.

The availability of highly purified lipoarabinomannan from Mycobacterium tuberculosis in its native acylated, highly antigenic state allowed its application to the serodiagnosis of tuberculosis in patients from the Republic of Mexico. Antilipoarabinomannan immunoglobulin G antibodies in sera from 66 patients with pulmonary, miliary, and pleural tuberculosis and tuberculosis lymphadenities were measured by using the enzyme-linked immunosorbent assay against sera from a control population of healthy individuals, people with histoplasmosis, and people with lung diseases not caused by mycobacteria. The results pointed to an unexpectedly high degree of specificity of 91% and a sensitivity of 72%, comparable to figures from previous studies with other purified antigens; most of the false-positive results were for patients with histoplasmosis. Thus, lipoarabinomannan of M. tuberculosis is a potentially useful antigen for the serodiagnosis of tuberculosis.