南非 HIV 阳性和 HIV 阴性患者眼内结核的诊断检测中，QuantiFERON-TB Gold 和结核菌素皮肤试验的作用。

The Role of QuantiFERON-TB Gold and Tuberculin Skin Test as Diagnostic Tests for Intraocular Tuberculosis in HIV-Positive and HIV-Negative Patients in South Africa.

机构信息

a Division of Ophthalmology, Faculty of Medicine and Health Sciences, Stellenbosch University , Cape Town , South Africa.

b Biostatistics Unit, Centre for Evidence Based Health Care, Faculty of Medicine and Health Sciences , Stellenbosch University , Cape Town , South Africa.

出版信息

Ocul Immunol Inflamm. 2018;26(6):853-858. doi: 10.1080/09273948.2017.1327078. Epub 2017 Jun 19.

DOI:10.1080/09273948.2017.1327078

PMID:28628340

Abstract

PURPOSE

To compare QuantiFERON®-TB Gold and tuberculin skin testing as diagnostic tests for intraocular tuberculosis in HIV positive and negative patients.

METHODS

A prospective study evaluating two different tests to help diagnose intraocular tuberculosis.

RESULTS

Thirty-five of 106 patients (33.0%) were diagnosed with intraocular tuberculosis including 11 (31.4%) with HIV infection. Patients were 6.95 times more likely to have intraocular tuberculosis if TST alone was positive (p < 0.001) versus 2.19 times more likely if Quantiferon alone was positive (p = 0.04). Tuberculin skin testing showed superior specificity (60.3% vs 33.3%) (p = 0.001) but similar sensitivity (90.3% vs 85.7%), positive (54.9% vs 40.5%) and negative predictive values (92.1% vs 81.5%) compared to Quantiferon. Specificity did not increase significantly if both skin testing and Quantiferon were positive.

CONCLUSIONS

In South Africa, with its high HIV burden and limited public health resources, Quantiferon testing should not replace tuberculin skin testing as it provides little additional diagnostic information.

摘要

目的

比较 QuantiFERON®-TB Gold 和结核菌素皮肤试验作为 HIV 阳性和阴性患者眼内结核的诊断检测。

方法

一项前瞻性研究评估了两种不同的测试，以帮助诊断眼内结核。

结果

106 名患者中有 35 名（33.0%）被诊断为眼内结核，包括 11 名（31.4%）HIV 感染者。如果 TST 单独阳性，患者发生眼内结核的可能性是 TST 单独阳性的 6.95 倍（p < 0.001），而如果 QuantiFERON 单独阳性，则可能性是 TST 单独阳性的 2.19 倍（p = 0.04）。结核菌素皮肤试验显示出更高的特异性（60.3%比 33.3%）（p = 0.001），但敏感性相似（90.3%比 85.7%），阳性（54.9%比 40.5%）和阴性预测值（92.1%比 81.5%）与 QuantiFERON 相比。如果结核菌素皮肤试验和 QuantiFERON 均为阳性，特异性并未显著增加。