Department of Infectious Diseases, Bellvitge University Hospital-Institut d'Investigació Biomèdica de Bellvitge (IDIBELL) 08907 Hospitalet de Llobregat, Barcelona, Spain.
Diagn Microbiol Infect Dis. 2011 Jan;69(1):59-65. doi: 10.1016/j.diagmicrobio.2010.09.005.
This study evaluated the QuantiFERON-TB Gold In-Tube (QFT-GIT; Cellestis, Carnegie, Australia) test and the tuberculin skin test (TST) for the detection of latent tuberculosis infection (LTBI) in HIV-infected adults. One hundred thirty-five HIV-seropositive persons and 135 controls underwent TST and QFT-GIT. HIV-infected patients who gave a positive result on either test were offered chemoprophylaxis. The prevalence of LTBI was 6.7% by TST and 9.6% by QFT-GIT (P = 0.3) in HIV-seropositive subjects, and 34.8% by TST and 21.5% by QFT-GIT (P = 0.02) among controls. TST reactivity declined sharply as CD4(+) cells fell (15.8%, 10.3%, and 0% for >500, 301-500 and ≤300 CD4(+) cells/mm(3), respectively; P = 0.002). A less pronounced fall occurred with QFT-GIT (15.8%, 13.8%, and 0% for >500, 301-500, and <100 CD4(+) cells/mm(3), respectively; P = 0.03). No cases of tuberculosis occurred during follow-up (0.26 per 100 person-years). Simultaneous testing with TST and QFT-GIT for targeting of chemoprophylaxis, early in the course of HIV infection, might minimize the risk of tuberculosis in these patients.
本研究评估了 QuantiFERON-TB Gold In-Tube（QFT-GIT；Cellestis，Carnegie，澳大利亚）检测和结核菌素皮肤试验（TST）在 HIV 感染成人中检测潜伏性结核感染（LTBI）的作用。135 例 HIV 血清阳性者和 135 例对照者接受了 TST 和 QFT-GIT 检测。对于 TST 和 QFT-GIT 检测阳性的 HIV 感染患者，给予化学预防。TST 和 QFT-GIT 检测的 LTBI 患病率分别为 HIV 血清阳性者中的 6.7%和 9.6%（P=0.3），对照者中分别为 34.8%和 21.5%（P=0.02）。TST 反应性随着 CD4（+）细胞的下降而急剧下降（>500、301-500 和 ≤300 CD4（+）细胞/mm3 时分别为 15.8%、10.3%和 0%；P=0.002）。QFT-GIT 反应性的下降则不太明显（>500、301-500 和 <100 CD4（+）细胞/mm3 时分别为 15.8%、13.8%和 0%；P=0.03）。随访期间无结核病发生（0.26 例/100 人年）。在 HIV 感染早期，同时进行 TST 和 QFT-GIT 检测以进行化学预防，可能会最大限度地降低这些患者发生结核病的风险。
