RT Journal Article
SR Electronic
T1 Concordance between tuberculin skin testing and interferon-gamma release assays in diagnosis of latent tuberculosis infection among HIV-infected individuals
JF European Respiratory Journal
JO Eur Respir J
FD European Respiratory Society
SP P423
VO 40
IS Suppl 56
A1 Adriana Socaci
A1 Gheorghe Nini
A1 Voicu Tudorache
A1 Teodora Moisil
A1 Erdin Borgazi
YR 2012
UL http://erj.ersjournals.com/content/40/Suppl_56/P423.abstract
AB Introduction: Detection and treatment of latent TB infection (LTBI) in HIV infected individuals is strongly recommended to decrease morbidity and mortality in countries with high levels of HIV. Interferon gamma release assays (IGRA) are now available alternatives to tuberculin skin test (TST) to detect LTBI Aims: This study compared QuantiFERON-TB Gold In-Tube (QFT-IT) with the TST for the detection of latent tuberculosis infection among HIV-infected individuals in an area with a high prevalence of tuberculosis (120%000), where BCG vaccination is mandatory. Methods: A prospective study of HIV-infected individuals with received the TST and an IGRA, the QFT-IT. Results: Of 147 participants, 106 (72.1%) returned for an evaluable TST. Concordance between QFT and TST was 88.8% (kappa = 0.37, p ≤0.001). However, in subjects with positive test results by either TST or QFT, only 27% (4/15) had positive test results by both modalities. TST-positive/QFT-negative discordant results were found in 5.1% of subjects and TST-negative/QFT-positive discordance in 6.1%. Indeterminate QFT results occurred in 5.4% (8/147), all due to a failure to respond to the phytohemagglutinin-positive control. Subjects with a CD4+ count of less than 100 cells/mm3 had a relative risk of an indeterminate result of 4.24 (p= 0.003) compared with those with a CD4+ count of 100 or more. Conclusions: Overall concordance between QFT and TST in HIV infection was high and similar to that seen in an immunocompetent population, but QFT testing may be limited by an elevated rate of indeterminate results in subjects with CD4+ cell counts of less than 100 cells/ mm3.