Xin H N, Li X W, Zhang L, Li Z, Zhang H R, Yang Y, Li M F, Feng B X, Li H J, Gao L
MOH Key Laboratory of Systems Biology of Pathogens,Institute of Pathogen Biology, and Center for Tuberculosis, Chinese Academy of Medical Sciences and Peking Union Medical College,Beijing,China.
Beijing Center for Disease Prevention and Control,Beijing,China.
Epidemiol Infect. 2017 Feb;145(3):498-502. doi: 10.1017/S0950268816002703. Epub 2016 Nov 21.
In individuals with latent tuberculosis (TB) infection, those living with human immunodeficiency virus (HIV) had a 20-37 times higher risk of developing active TB compared to those without HIV infection. Systematic testing and treatment of latent TB infection are priorities in HIV-infected persons. In China, the prevalence of HIV infection in men who have sex with men (MSM) has gradually increased in the past decade. However, the prevalence of TB infection has been studied sparsely in HIV-infected MSM. Hence, we conducted a pilot study in MSM living with HIV infection in Xi'an city to evaluate TB infection status by means of interferon-γ release assay (IGRA). A total of 182 HIV-infected MSM were included in this study, the prevalence of IGRA positivity was observed to be 8·79% (16/182). IGRA quantitative results were not statistically influenced by the CD4 cell counts of the study participants. However, IGRA positivity was found to be lower than our previously reported data from the general population. This suggests that immunological deficiency might decrease the sensitivity of IGRA and thus increase the number of false negatives. Our primary results, suggesting systematic testing and treatment of latent TB infection together with active case-finding, were equally important for TB control in persons living with HIV infection.
在潜伏性结核感染个体中,与未感染人类免疫缺陷病毒(HIV)的个体相比,感染HIV的个体发生活动性结核的风险高20至37倍。对潜伏性结核感染进行系统检测和治疗是HIV感染者的优先事项。在中国,过去十年间男男性行为者(MSM)中HIV感染率逐渐上升。然而,对HIV感染的MSM中结核感染率的研究却很少。因此,我们在西安市对感染HIV的MSM开展了一项试点研究,通过干扰素-γ释放试验(IGRA)评估结核感染状况。本研究共纳入182例感染HIV的MSM,观察到IGRA阳性率为8.79%(16/182)。IGRA定量结果不受研究参与者CD4细胞计数的统计学影响。然而,发现IGRA阳性率低于我们之前报告的普通人群数据。这表明免疫缺陷可能会降低IGRA的敏感性,从而增加假阴性数量。我们的主要结果表明,对潜伏性结核感染进行系统检测和治疗以及主动病例发现,对HIV感染者的结核控制同样重要。