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Peer-reviewedCC BYInternational journal of microbiology

Diagnostic Accuracy of the Three-Gene Host-Response Test in Blood for Tuberculosis: A Systematic Review.

  • Carlos Quispe-Vicuña1
  • Dante Julca-Marín2,3
  • Milagros Pascual-Guevara4
  • Fabian A Chavez Ecos1
  • Carlos J Zumaran-Nuñez5
  • Fritz Fidel Váscones-Román6,7,8
  • Carlomagno Villarreal-Inca3
  • Miguel Cabanillas-Lazo1
  • Luz Quispe-Garate3
  • Elizabeth F Hidalgo Ferrer3
  • J Smith Torres-Roman9
  • Julio A Poterico4
2 more authors
  • Miguel A Arce-Huamani10
  • Vicente Benitez-Zapata11
11 affiliations
  1. 1NEMECS Research Group: Neuroscience, Metabolism, Clinical and Health Effectiveness Universidad Científica del Sur Lima Peru cientifica.edu.pe.
  2. 2Sociedad Científica de San Fernando Lima Peru.
  3. 3Facultad de Medicina Universidad Nacional Mayor de San Marcos Lima Peru unmsm.edu.pe.
  4. 4Universidad de Huánuco Huánuco Peru.
  5. 5Universidad Señor de Sipán Chiclayo Peru.
  6. 6Departamento de Neurocirugía Instituto Nacional de Ciencias Neurológicas Lima Peru.
  7. 7Harvard T.H. Chan School of Public Health Harvard University Boston Massachusetts USA harvard.edu.
  8. 8Facultad de Medicina Universidad Peruana Cayetano Heredia Lima Peru upch.edu.pe.
  9. 9Graduate School Universidad Continental Lima Peru ucontinental.edu.pe.
  10. 10Public Health Surveillance and Applied Research Programa Academico de Medicina Humana Facultad de Ciencias de la Salud Universidad Privada Norbert Wiener Lima Peru anahuac.mx.
  11. 11Universidad Científica del Sur Lima Peru cientifica.edu.pe.
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Abstract

Molecular diagnostic tests and sputum-based assays are common techniques for the initial evaluation of tuberculosis (TB). However, given their limitations in certain clinical contexts, efforts have been made to develop other diagnostic markers. This review evaluated the diagnostic accuracy of a three-gene host-response test (TB score) for the diagnosis of TB. We performed systematic searches in seven databases until July 2026. We included observational studies evaluating the diagnostic accuracy of the TB score to diagnosis of TB across different clinical contexts. Risk of bias was assessed using QUADAS-2. Meta-analysis was performed using the logit function, and GRADE was employed to assess certainty of evidence (CoE). Twenty-eight studies were included. For distinguishing pulmonary TB from other respiratory diseases, the TB score showed a pooled sensitivity and specificity of 0.80 (95% CI: 0.73-0.84) and 0.72 (95% CI: 0.64-0.78), respectively, with an AUC of 0.82. When comparing pulmonary TB to healthy controls, sensitivity was 0.75 and specificity was 0.86, with an AUC of 0.87. Performance was lower for meningeal tuberculosis (sensitivity 0.58; specificity 0.67) and for distinguishing active from latent TB (sensitivity 0.73; specificity 0.76). Risk of bias was generally low. The CoE for most outcomes was very low. The TB score shows moderate diagnostic accuracy for pulmonary TB, with pooled sensitivity below the WHO TPP minimum for a standalone triage test. High heterogeneity and very low CoE limit confidence in these findings. Its potential role as a complementary tool remains investigational and requires validation in prospective studies.

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Cite

BibTeXRIS
BibTeX
@article{quispevicuna2026diagnostic,
  title = {{Diagnostic Accuracy of the Three-Gene Host-Response Test in Blood for Tuberculosis: A Systematic Review.}},
  author = {Carlos Quispe-Vicuña and Dante Julca-Marín and Milagros Pascual-Guevara and Fabian A Chavez Ecos and Carlos J Zumaran-Nuñez and Fritz Fidel Váscones-Román and Carlomagno Villarreal-Inca and Miguel Cabanillas-Lazo and Luz Quispe-Garate and Elizabeth F Hidalgo Ferrer and J Smith Torres-Roman and Julio A Poterico and Miguel A Arce-Huamani and Vicente Benitez-Zapata},
  journal = {International journal of microbiology},
  year = {2026},
  month = nov,
  doi = {10.1155/ijm/3402245},
  url = {https://europepmc.org/article/MED/42999489},
  note = {CC BY},
}
RIS
TY  - JOUR
TI  - Diagnostic Accuracy of the Three-Gene Host-Response Test in Blood for Tuberculosis: A Systematic Review.
AU  - Carlos Quispe-Vicuña
AU  - Dante Julca-Marín
AU  - Milagros Pascual-Guevara
AU  - Fabian A Chavez Ecos
AU  - Carlos J Zumaran-Nuñez
AU  - Fritz Fidel Váscones-Román
AU  - Carlomagno Villarreal-Inca
AU  - Miguel Cabanillas-Lazo
AU  - Luz Quispe-Garate
AU  - Elizabeth F Hidalgo Ferrer
AU  - J Smith Torres-Roman
AU  - Julio A Poterico
AU  - Miguel A Arce-Huamani
AU  - Vicente Benitez-Zapata
PY  - 2026
DA  - 2026/11/06
JO  - International journal of microbiology
DO  - 10.1155/ijm/3402245
UR  - https://europepmc.org/article/MED/42999489
AB  - Molecular diagnostic tests and sputum-based assays are common techniques for the initial evaluation of tuberculosis (TB). However, given their limitations in certain clinical contexts, efforts have been made to develop other diagnostic markers. This review evaluated the diagnostic accuracy of a three-gene host-response test (TB score) for the diagnosis of TB. We performed systematic searches in seven databases until July 2026. We included observational studies evaluating the diagnostic accuracy of the TB score to diagnosis of TB across different clinical contexts. Risk of bias was assessed using QUADAS-2. Meta-analysis was performed using the logit function, and GRADE was employed to assess certainty of evidence (CoE). Twenty-eight studies were included. For distinguishing pulmonary TB from other respiratory diseases, the TB score showed a pooled sensitivity and specificity of 0.80 (95% CI: 0.73-0.84) and 0.72 (95% CI: 0.64-0.78), respectively, with an AUC of 0.82. When comparing pulmonary TB to healthy controls, sensitivity was 0.75 and specificity was 0.86, with an AUC of 0.87. Performance was lower for meningeal tuberculosis (sensitivity 0.58; specificity 0.67) and for distinguishing active from latent TB (sensitivity 0.73; specificity 0.76). Risk of bias was generally low. The CoE for most outcomes was very low. The TB score shows moderate diagnostic accuracy for pulmonary TB, with pooled sensitivity below the WHO TPP minimum for a standalone triage test. High heterogeneity and very low CoE limit confidence in these findings. Its potential role as a complementary tool remains investigational and requires validation in prospective studies.
SN  - 1687-918X
SN  - 1687-9198
ER  -