印度不同孕期第三代和第四代结核感染T细胞检测（QuantiFERON-TB Gold）结果的不一致性
Discordance of 3rd and 4th generation QuantiFERON-TB Gold assays by pregnancy stages in India.
作者信息
Kulkarni Vandana, Alexander Mallika, Bhosale Ramesh, Jain Divyashri, Deshpande Prasad, Gitlin Emily Shira, Vaidyanathan Arthi, Chalem Andrea, Naik Shilpa, Gupte Nikhil, Nawani Neelu, Gupta Amita, Mathad Jyoti
机构信息
Byramjee-Jeejeebhoy Government Medical College-Johns Hopkins University Clinical Research Site, 3rd Floor, Infosys Superspecialty Building, Byramjee Jeejeebhoy Government Medical College & Sassoon General Hospitals, Jai Prakash Narayan Road, Pune 411001, India.
Center for Infectious Diseases in India, Johns Hopkins India, G Block, C1 Shopping Arcade, Konark Estate, Cannaught Road, Pune 411001, India.
出版信息
J Clin Tuberc Other Mycobact Dis. 2024 Dec 4;38:100504. doi: 10.1016/j.jctube.2024.100504. eCollection 2025 Feb.
BACKGROUND
Pregnancy and HIV affect CD4+ T lymphocytes and impact performance of QuantiFERON-TB Gold (QFT). We compared the results of QFT with QuantiFERON-TB Gold Plus (QFT-Plus), which also measures CD8+ responses to TB antigens, during pregnancy and postpartum.
METHODS
We screened 516 pregnant women for TB infection (TBI) with IGRA. From 165 IGRA + pregnant women, QFT vs QFT-Plus results were compared at delivery and postpartum. Longitudinal changes in QFT-Plus were assessed in 74 pregnant women who received QFT-Plus testing at pregnancy, delivery, and postpartum.
RESULTS
Through cross-sectional analysis of the IGRA + cohort, QFT-Plus showed higher positivity than QFT (80 % vs 65 %, p = 0.04) at delivery but no difference postpartum. Among 35 women with HIV, QFT-Plus returned more positive results than QFT at delivery and postpartum (76 % vs 47 %, p = 0.08; 90 % vs 80 %, p = 0.54), though not statistically significant. Longitudinally, QFT-Plus positivity by TB1 or TB2 was highest antepartum vs. delivery and postpartum (74 % vs. 58 % vs. 62 %; p = 0.09) and performed better than TB1 alone (100 % vs 90 %, p = 0.04) in women without HIV but not in women with HIV.
CONCLUSIONS
Performance of QFT-Plus was consistent across pregnancy, including at delivery when QFT positivity is lower. QFT-Plus may enhance antenatal TBI detection among pregnant women.
背景
妊娠和HIV会影响CD4+ T淋巴细胞，并对结核感染T细胞检测（QFT）的结果产生影响。我们比较了妊娠期间及产后QFT与结核感染T细胞检测增强版（QFT-Plus）的结果，后者还可检测对结核抗原的CD8+反应。
方法
我们用全血γ干扰素释放试验（IGRA）对516名孕妇进行结核感染（TBI）筛查。在165名IGRA检测呈阳性的孕妇中，比较了分娩时及产后QFT与QFT-Plus的检测结果。对74名在孕期、分娩时及产后接受QFT-Plus检测的孕妇，评估了QFT-Plus的纵向变化。
结果
通过对IGRA检测呈阳性队列的横断面分析，分娩时QFT-Plus的阳性率高于QFT（80%对65%，p = 0.04），但产后无差异。在35名感染HIV的女性中，分娩时及产后QFT-Plus的阳性结果多于QFT（76%对47%，p = 0.08；90%对80%，p = 0.54），尽管差异无统计学意义。纵向来看，TB1或TB2检测的QFT-Plus阳性率在产前最高，高于分娩时及产后（74%对58%对62%；p = 0.09），在未感染HIV的女性中，其表现优于单独的TB1检测（100%对90%，p = 0.04），但在感染HIV的女性中并非如此。
结论
QFT-Plus在整个孕期的表现一致，包括在QFT阳性率较低的分娩时。QFT-Plus可能会提高孕妇产前TBI的检测率。
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