Department of Medicine, University of Pennsylvania, Philadelphia, PA 19019, USA.
BMC Infect Dis. 2011 Sep 30;11:264. doi: 10.1186/1471-2334-11-264.
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).
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.
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).
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.
关于 HIV 状态和 CD4 计数对潜伏性结核感染（LTBI）诊断用干扰素释放试验（IGRAs）的检测结果的影响，目前仅有有限的数据。
本横断面研究旨在评估赞比亚 HIV 不一致夫妇中，结核菌素皮肤试验（TST）和 IGRAs 用于 LTBI 诊断的阳性检测结果的流行率和危险因素。
共纳入 596 名受试者（298 对夫妇）。HIV 阳性者的中位 CD4 计数为 388 个细胞/μl（范围 51-1330）。HIV 阴性者比其 HIV 阳性伴侣更有可能通过 TST（203 对 128）、QFT（171 对 109）和 TSPOT（156 对 109）检测出 LTBI 阳性诊断结果。多变量分析显示，HIV 阴性状态是 QFT（比值比[OR] = 2.22，95%置信区间[CI] 1.42-3.46）和 TSPOT（OR = 1.79，95% CI 1.16-2.77）阳性的独立预测因素。在 HIV 阳性者中，CD4 计数≥388 个细胞/μl 与 TST（OR = 1.76，95% CI 1.10-2.82）和 QFT（OR = 1.71，95% CI 1.06-2.77）阳性相关，但与 TSPOT 无关（OR = 1.20，95% CI 0.74-1.94）。
HIV 感染者 TST、QFT 和 TSPOT 检测出 LTBI 的阳性诊断结果明显较少。CD4 计数<388 个细胞/μl 的患者不太可能 TST 或 QFT 阳性，但 TSPOT 阳性的可能性不大。TSPOT 在 HIV 阳性个体中的表现可能优于 TST 或 QFT。
