Guangxi Key Laboratory of Major Infectious Disease Prevention and Control and Biosafety Emergency Response, Nanning 530028, China.
Guangxi Zhuang Autonomous Region Center for Disease Control and Prevention, Nanning 530028, China.
Int J Environ Res Public Health. 2023 Mar 4;20(5):4556. doi: 10.3390/ijerph20054556.
Latent tuberculosis is prevalent in HIV-infected people and has an impact on the progression of AIDS. The aim of this study is to match a more accurate IGRA method for the better detection of latent tuberculosis infection in HIV patients. All 2394 patients enrolled were tested using three IGRA methods. The positive rate consistency of pairwise comparison and risk factors were analyzed. Receiver operator characteristic (ROC) curve analysis was applied to evaluate the diagnostic value of T-SPOTTB. The positive rates of the three methods were statistically different ( < 0.001). The CD4 T cell number statistically impacted the QuantiFERON and Wan Tai tests after the analysis with univariate logistic regression, while no statistical difference was observed in T-SPOT.TB. Additionally, there was a better sensitivity and specificity of T-SPOT.TB if the positive cut-off value of ESAT-6 and CFP-10 was 4.5 and 5.5, respectively. This study provides an insight into the IGRA methods and demonstrated that the positive response detected via QuantiFERON declined with decreased CD4 T cells in the HIV-infected population; T-SPOT.TB functions independently of the CD4 T cell level and Wan Tai was affected in some cases. This will be useful in the diagnosis of LTBI in the HIV-infected population, which will be a key step toward TB elimination in China.
潜伏性结核在 HIV 感染者中较为普遍,对 AIDS 的进展有影响。本研究旨在为 HIV 患者潜伏性结核感染的更好检测匹配更准确的 IGRA 方法。所有 2394 名入组患者均使用三种 IGRA 方法进行检测。分析了两两比较的阳性率一致性和危险因素。应用受试者工作特征(ROC)曲线分析 T-SPOTTB 的诊断价值。三种方法的阳性率存在统计学差异(<0.001)。单因素逻辑回归分析显示,CD4 T 细胞计数对 QuantiFERON 和 Wan Tai 试验有统计学影响,而 T-SPOT.TB 则无统计学差异。此外,如果 ESAT-6 和 CFP-10 的阳性截断值分别为 4.5 和 5.5,T-SPOT.TB 的灵敏度和特异性更好。本研究深入探讨了 IGRA 方法,并表明 QuantiFERON 检测的阳性反应随着 HIV 感染者 CD4 T 细胞的减少而降低;T-SPOT.TB 独立于 CD4 T 细胞水平,而 Wan Tai 在某些情况下受到影响。这将有助于诊断 HIV 感染者中的 LTBI,这将是中国消除结核病的关键一步。