Abstract
Objective: to determine and compare parameters of diagnostic value of immunological tests in the diagnosis of tuberculosis in patients with HIV infection.
Materials and methods: During 2013-2014 years' cohort study was conducted. Were examined 88 patients with HIV infection and healthy people (control group – n=18). Diagnostic complex included: QuantiFERON®-TB Gold (QFT), TB.SPOT, X-ray, sputum smear examination, cultural and PCR methods. Patients were divided into two groups: I- HIV(n=41) and II -HIV + TB(n = 43).
Results: Data of immunological study are presented in table.
TB.SPOT(n/%) | QFT(n/%) | |||||
Patients | Pos. | Doub. | Neg. | Pos. | Doub. | Neg. |
I group (41) | 26.8/11 | 4.9/2 | 68.3*/28 | 29.2/12 | 0 | 70.7**/29 |
II group (43) | 83.8*/36 | 6.9/3 | 9.3/4 | 79.1**/34 | 4.6/2 | 16.3/ |
control group (18) | 22.2/2 | 5.5/1 | 83.3*** /15 | 16.7/3 | 5.5/1 | 77.8*** /14 |
* p<0,01 compared I and II ** p<0,001 compared I and II ***p<0,001 compared II and III
Results of immunological tests in groups
Significant results were obtained in group II with a positive test result for both TB.SPOT, and QFT. RR for positive result of TB.SPOT (RR = 3.3) in group II was twice higher than QFT (RR = 2.5). In group I, RR of positive result for TB.SPOT (RR = 0,3) was comparable with QFT (RR = 0,2). Indicators of the diagnostic significance of TB.SPOT (Se = 90.0%, Sp = 88.2%, DV = 89.1%) and QFT (Se = 82.9%, Sp = 82.4%, DV= 82.7%) were comparable.
Conclusions: Results of TB.SPOT was slightly higher than QFT in the diagnosis of tuberculosis infection in patients with HIV. Risk factor for a positive result TB.SPOT two times higher than the figure QFT, which significantly increases the ability to detect latent TB infection in patients with HIV.
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