Interleukin-18 as an Immunological Biomarker in Latent and Active Tuberculosis: A Systematic Literature Review (2016-2026)

DOI

10.2991/978-94-6239-807-8_4How to use a DOI?

Keywords

Interleukin-18; Tuberculosis; Active; Latent; Biomarker

Abstract

The persistence of tuberculosis (TB) remains a global health concern; approximately a quarter of the population carries a latent TB infection (LTBI), with 5-10% advancing to active disease. Current assays, like interferon-gamma release assays and tuberculin skin tests, cannot reliably differentiate contained latent infection from clinically active tuberculosis (ATB). Interleukin-18 (IL-18), a pro-inflammatory cytokine driving host immune responses to Mycobacterium tuberculosis, has emerged as a promising candidate to distinguish TB stages. This systematic review synthesizes the diagnostic effectiveness of IL-18 in differentiating LTBI from ATB. A PRISMA-compliant literature search in Google Scholar and PubMed (2016–2026) screened 664 initial records, including 13 quantitative studies in the final synthesis. Evidence reveals standalone IL-18 demonstrates weak-to-moderate diagnostic accuracy (AUC 0.71–0.83) for differentiating ATB from LTBI, falling short of WHO target profiles for independent triage tests. However, diagnostic precision improves substantially within multi-biomarker panels. Concentration trends indicate significantly higher IL-18 levels in ATB compared to LTBI across serum, plasma, and antigen-stimulated samples. Crucially, this trend is context-dependent: it correlates strongly with disease severity and reverses entirely in extrapulmonary manifestations like tuberculous lymphadenitis, where IL-18 is suppressed at the infection site. Additionally, longitudinal data show IL-18 levels reliably normalize following successful anti-tuberculosis therapy. While IL-18 is insufficient as a standalone rapid test, it acts as a dynamic, context-sensitive biomarker that provides significant clinical value when integrated into multi-analyte diagnostic panels and used for longitudinal treatment monitoring.

Copyright

© 2026 The Author(s)

Open Access

Open Access This chapter is licensed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License (http://creativecommons.org/licenses/by-nc/4.0/), which permits any noncommercial use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license and indicate if changes were made.

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TY  - CONF
AU  - Dina Fauziah
AU  - Fitria Nugraha Aini
PY  - 2026
DA  - 2026/10/24
TI  - Interleukin-18 as an Immunological Biomarker in Latent and Active Tuberculosis: A Systematic Literature Review (2016-2026)
BT  - Proceedings of the Malang International Conference on Medical and Health Sciences (MICROMEDHS 2026)
PB  - Atlantis Press
SP  - 30
EP  - 43
SN  - 2468-5739
UR  - https://doi.org/10.2991/978-94-6239-807-8_4
DO  - 10.2991/978-94-6239-807-8_4
ID  - Fauziah2026
ER  -