Baumeister, Carl RobertVerschoor, Jan AdrianusUeckermann, VeronicaMolatseli, MosaSesing, ThorisoKhuboni, NomthandazoFourie, Bernard P.2025-11-192025-11-192025Baumeister, C., Verschoor, J., Ueckermann, V. et al. 2025, 'Electro-impedimetric detection of human anti-mycolate antibody biomarkers of TB before, during, and after treatment', Biomarkers in Medicine, vol. 19, no. 16, pp. 769-782. https://doi.org/10.1080/17520363.2025.2548196.1752-0363 (print)1752-0371 (online)10.1080/17520363.2025.2548196http://hdl.handle.net/2263/105360DATA AVAILABILITY STATEMENT : All data required is included within the text of the manuscript.Efficient TB management requires rapid and accurate diagnosis of active pulmonary and extrapulmonary TB at the point-of-care. Blood-based antibody biomarker assays may be ideal if unaffected by HIV co-infection and antibody memory from prior TB or vaccination. AIM : This study assessed electro-impedimetric detection (EIS-MARTI) of anti-mycolate antibodies (AMAb) in TB patients before, during, and after treatment, compared to sputum culture (MGIT) as the gold standard. METHODS : A prospective pilot study enrolled 15 confirmed TB patients and 73 healthy controls at a Pretoria hospital (2016–2017). A prospective monitoring study followed 25 confirmed TB patients over 6 months of treatment at a Pretoria clinic (2019–2020) to evaluate biomarker behavior. Outcomes were analyzed using descriptive statistics, wherein diagnostic accuracy and predictive values were assessed by ROC curve analysis. RESULTS : EIS-MARTI detected 14/15 true TB-positive cases independent of HIV co-infection and 68/73 true TB-negatives in the pilot study. In the monitoring study, EIS-MARTI correlated with culture in 7/8 cases at treatment end, but not during the first 2 months. CONCLUSION : AMAbs arise independently of HIV co-infection in active TB, recede during treatment, and are rapidly detected by a hand-held EIS-MARTI device. While suitability for treatment monitoring remains uncertain, EIS-MARTI shows promise for rapid, accurate TB diagnosis and confirming cure. PLAIN LANGUAGE SUMMARY : The purpose of this work was to investigate anti-mycolate antibodies as a suitable biomarker for diagnosing tuberculosis, monitoring treatment, and screening people at risk for TB.en© 2025 University of Pretoria. This is an Open Access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License.Tuberculosis (TB)Antibody biomarker for TBHandheld TB diagnosticTB screeningTB serodiagnosisTB immunosensorAntimycolate antibodiesMycolic acidsArticle