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比较 HIV 感染患者中干扰素γ诱导蛋白-10 和基于干扰素γ的 QuantiFERON TB Gold 检测与结核菌素皮肤试验。

Comparison of interferon gamma-inducible protein-10 and interferon gamma-based QuantiFERON TB Gold assays with tuberculin skin test in HIV-infected subjects.

机构信息

Department of Immunology, Tuberculosis Research Centre (ICMR), Chetput, Chennai 600 031, Tamil Nadu, India.

出版信息

Diagn Microbiol Infect Dis. 2011 Nov;71(3):236-43. doi: 10.1016/j.diagmicrobio.2011.07.012.

Abstract

We aimed to compare the positivity of the QuantiFERON TB gold in-tube (QFT-IT antigens) specific interferon gamma (IFN-γ/QFT-IT) and IFN-γ-inducible protein-10 (IP-10/QFT-IT) assays with tuberculin skin test (TST) among human immunodeficiency virus (HIV)-infected individuals in a TB endemic setting. A total of 180 HIV-infected subjects, with no evidence of active TB, were recruited. IFN-γ and IP-10 levels specific to QFT-IT antigens were measured in plasma from QFT-IT tubes. The overall positivity of TST at the 5-mm cut-off point (19%) was significantly lower when compared to IFN-γ/QFT-IT (38%) and IP-10/QFT-IT (45%) assays. The positivity of IP-10/QFT-IT was significantly higher than that of IFN-γ/QFT-IT (P = 0.038). Indeterminate results for IFN-γ/QFT-IT and IP-10/QFT-IT were more frequent in subjects with CD4 count <100 cells/μL than in those with >100 cells/μL. IFN-γ/QFT-IT (9%) yielded significantly higher number of indeterminate results than IP-10/QFT-IT (5%). The frequency of these responses is higher than the proportion of individuals with positive TST results. However, 6 IFN-γ/QFT-IT- or IP-10/QFT-IT-negative subjects were positive for TST at the 5-mm cut-off point. Prospective and prognostic studies are required to clarify the significance of these data.

摘要

我们旨在比较在结核病流行地区人类免疫缺陷病毒(HIV)感染个体中,结核菌素皮肤试验(TST)与 QuantiFERON TB gold in-tube(QFT-IT 抗原)特异性干扰素γ(IFN-γ/QFT-IT)和干扰素诱导蛋白-10(IP-10/QFT-IT)检测的阳性率。共招募了 180 名无活动性结核病证据的 HIV 感染患者。从 QFT-IT 管中测量了针对 QFT-IT 抗原的 IFN-γ 和 IP-10 水平。与 IFN-γ/QFT-IT(38%)和 IP-10/QFT-IT(45%)检测相比,5mm 截断值(19%)的 TST 总体阳性率显著降低。IP-10/QFT-IT 的阳性率明显高于 IFN-γ/QFT-IT(P=0.038)。CD4 计数<100 个/μL 的患者中 IFN-γ/QFT-IT 和 IP-10/QFT-IT 不确定结果比 CD4 计数>100 个/μL 的患者更常见。IFN-γ/QFT-IT(9%)比 IP-10/QFT-IT(5%)产生的不确定结果数量显著更多。这些反应的频率高于 TST 阳性结果的个体比例。然而,6 名 IFN-γ/QFT-IT 或 IP-10/QFT-IT 阴性的患者 TST 在 5mm 截断值处呈阳性。需要前瞻性和预后研究来阐明这些数据的意义。

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