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Diagnosis of latent tuberculosis infection among HIV discordant partners using interferon gamma release assays.

Talati NJ, Gonzalez-Diaz E, Mutemba C, Wendt J, Kilembe W, Mwananyanda L, Chomba E, Allen S, del Rio C, Blumberg HM - BMC Infect. Dis. (2011)

Bottom Line: There is limited data on the effect of HIV status and CD4 counts on performance of Interferon-g Release assays (IGRAs) for diagnosis of latent tuberculosis infection (LTBI).Among HIV positive subjects a CD4 count ≥ 388 cells/μl was associated with a positive TST (OR = 1.76 95% CI 1.10-2.82) and QFT (OR = 1.71 95% CI 1.06-2.77) but not TSPOT (OR = 1.20 95% CI 0.74-1.94).TSPOT may perform better than TST or QFT in HIV positive individuals.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Medicine, University of Pennsylvania, Philadelphia, PA 19019, USA. naashatalati@yahoo.com

ABSTRACT

Background: There is limited data on the effect of HIV status and CD4 counts on performance of Interferon-g Release assays (IGRAs) for diagnosis of latent tuberculosis infection (LTBI).

Methods: A cross sectional study was conducted to assess the prevalence of and risk factors for a positive diagnostic test for LTBI, using tuberculin skin test (TST) and IGRAs among HIV-discordant couples in Zambia.

Results: A total of 596 subjects (298 couples) were enrolled. Median CD4 count among HIV positive persons was 388 cells/μl, (range 51-1330). HIV negative persons were more likely than their HIV positive partner, to have a positive diagnostic test for LTBI with TST (203 vs 128), QFT (171 vs 109) and TSPOT (156 vs. 109). On multivariate analysis, HIV negative status was an independent predictor for a positive QFT (OR = 2.22, 95% CI 1.42- 3.46) and TSPOT (OR = 1.79, 95% CI 1.16-2.77). Among HIV positive subjects a CD4 count ≥ 388 cells/μl was associated with a positive TST (OR = 1.76 95% CI 1.10-2.82) and QFT (OR = 1.71 95% CI 1.06-2.77) but not TSPOT (OR = 1.20 95% CI 0.74-1.94).

Conclusions: Persons with HIV had significantly fewer positive diagnostic tests for LTBI with TST, QFT and TSPOT. Persons with a CD4 count < 388 cells/μl were less likely to have a positive TST or QFT, but not less likely to have a positive TSPOT. TSPOT may perform better than TST or QFT in HIV positive individuals.

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Related in: MedlinePlus

Enrollment of Study Subjects from ZEHRP Cohort.
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Figure 1: Enrollment of Study Subjects from ZEHRP Cohort.

Mentions: Out of a cohort of 546 HIV-discordant couples currently enrolled at ZEHRP 403 couples met the prescreening criteria for study enrollment. The cross section for this study consists of 298 discordant couples or 596 study subjects (Figure 1). The median age of study participants was 33 years (range 17-59 years), median monthly income was the equivalent of US $32 (range US $ 0-1908). Women were significantly more likely to be HIV positive than men (60% vs 40%, p < 0.0001). Median CD4 count among HIV positive persons was 388 cells/μl, (range 51-1330 cells/μl). None of the study subjects were on antiretroviral therapy.


Diagnosis of latent tuberculosis infection among HIV discordant partners using interferon gamma release assays.

Talati NJ, Gonzalez-Diaz E, Mutemba C, Wendt J, Kilembe W, Mwananyanda L, Chomba E, Allen S, del Rio C, Blumberg HM - BMC Infect. Dis. (2011)

Enrollment of Study Subjects from ZEHRP Cohort.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3198954&req=5

Figure 1: Enrollment of Study Subjects from ZEHRP Cohort.
Mentions: Out of a cohort of 546 HIV-discordant couples currently enrolled at ZEHRP 403 couples met the prescreening criteria for study enrollment. The cross section for this study consists of 298 discordant couples or 596 study subjects (Figure 1). The median age of study participants was 33 years (range 17-59 years), median monthly income was the equivalent of US $32 (range US $ 0-1908). Women were significantly more likely to be HIV positive than men (60% vs 40%, p < 0.0001). Median CD4 count among HIV positive persons was 388 cells/μl, (range 51-1330 cells/μl). None of the study subjects were on antiretroviral therapy.

Bottom Line: There is limited data on the effect of HIV status and CD4 counts on performance of Interferon-g Release assays (IGRAs) for diagnosis of latent tuberculosis infection (LTBI).Among HIV positive subjects a CD4 count ≥ 388 cells/μl was associated with a positive TST (OR = 1.76 95% CI 1.10-2.82) and QFT (OR = 1.71 95% CI 1.06-2.77) but not TSPOT (OR = 1.20 95% CI 0.74-1.94).TSPOT may perform better than TST or QFT in HIV positive individuals.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Medicine, University of Pennsylvania, Philadelphia, PA 19019, USA. naashatalati@yahoo.com

ABSTRACT

Background: There is limited data on the effect of HIV status and CD4 counts on performance of Interferon-g Release assays (IGRAs) for diagnosis of latent tuberculosis infection (LTBI).

Methods: A cross sectional study was conducted to assess the prevalence of and risk factors for a positive diagnostic test for LTBI, using tuberculin skin test (TST) and IGRAs among HIV-discordant couples in Zambia.

Results: A total of 596 subjects (298 couples) were enrolled. Median CD4 count among HIV positive persons was 388 cells/μl, (range 51-1330). HIV negative persons were more likely than their HIV positive partner, to have a positive diagnostic test for LTBI with TST (203 vs 128), QFT (171 vs 109) and TSPOT (156 vs. 109). On multivariate analysis, HIV negative status was an independent predictor for a positive QFT (OR = 2.22, 95% CI 1.42- 3.46) and TSPOT (OR = 1.79, 95% CI 1.16-2.77). Among HIV positive subjects a CD4 count ≥ 388 cells/μl was associated with a positive TST (OR = 1.76 95% CI 1.10-2.82) and QFT (OR = 1.71 95% CI 1.06-2.77) but not TSPOT (OR = 1.20 95% CI 0.74-1.94).

Conclusions: Persons with HIV had significantly fewer positive diagnostic tests for LTBI with TST, QFT and TSPOT. Persons with a CD4 count < 388 cells/μl were less likely to have a positive TST or QFT, but not less likely to have a positive TSPOT. TSPOT may perform better than TST or QFT in HIV positive individuals.

Show MeSH
Related in: MedlinePlus