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

作者：Talati Naasha J^*; Gonzalez Diaz Esteban; Mutemba Charles; Wendt Joyanna; Kilembe William; Mwananyanda Lawrence; Chomba Elwyn; Allen Susan; del Rio Carlos; Blumberg Henry M

来源：BMC Infectious Diseases, 2011, 11: 264.

DOI：10.1186/1471-2334-11-264

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/mu l, (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/mu l 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/mu l 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.

• 出版日期2011-9-30