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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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Positive diagnostic test for latent tuberculosis infection stratified by CD4 count (n = 298).
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Figure 2: Positive diagnostic test for latent tuberculosis infection stratified by CD4 count (n = 298).

Mentions: Among HIV -seropositive individuals, subjects with a CD4 count < 388 cells/μl were less likely to have a positive test with TST and QFT, when compared to subjects with CD4 count ≥ 388 cells/μl. This difference was not seen with TSPOT (Figure 2).


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)

Positive diagnostic test for latent tuberculosis infection stratified by CD4 count (n = 298).
© Copyright Policy - open-access
Related In: Results  -  Collection

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

Figure 2: Positive diagnostic test for latent tuberculosis infection stratified by CD4 count (n = 298).
Mentions: Among HIV -seropositive individuals, subjects with a CD4 count < 388 cells/μl were less likely to have a positive test with TST and QFT, when compared to subjects with CD4 count ≥ 388 cells/μl. This difference was not seen with TSPOT (Figure 2).

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