Lu Peng, Yang Haitao, Ge Fang, Wu Kai, Lian Yilin, Ding Xiaoyan, Pan Jingjing, Ding Hui, Lu Wei, Liu Qiao, Zhu Limei
Department of Chronic Communicable Disease, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, China.
Department of Epidemiology, Key Laboratory of Public Health Safety and Emergency Prevention and Control Technology of Higher Education Institutions in Jiangsu Province, School of Public Health, Nanjing Medical University, Nanjing, China.
PeerJ. 2025 Mar 31;13:e19195. doi: 10.7717/peerj.19195. eCollection 2025.
No direct comparative study assessing QuantiFERON-TB Gold In-Tube (QFT-GIT) and QuantiFERON-TB Gold Plus (QFT-Plus) for infection among persons living with HIV (PLHIV) in China has been conducted.
Simultaneous QFT-GIT and QFT-Plus tests were conducted on PLHIV in a prison hospital. Positivity and negativity results from both assays were compared, and their diagnostic agreement was assessed.
A total of 232 PLHIV individuals were included in this study. Among them, 57 patients (24.6%) and 56 patients (24.1%) were diagnosed with infection based on QFT-GIT results and QFT-Plus, respectively. The overall agreement between the two assays was 98.3%, with a Cohen's kappa value of 0.954. Consistency rates were observed between QFT-GIT plus, QFT-Plus TB1 and TB2 with QFT-GIT were 98.3%, 97.4% and 97.8%. The IFN-γ levels measured in QFT-GIT were found to surpass those in QFT-Plus TB1 ( = 0.04), while the difference compared to QFT-Plus TB2 exhibited a marginal trend ( = 0.134). Among the subgroup of 52 individuals who underwent dual QFT-GIT tests, a significant proportion of 23.1% (12 individuals) experienced a change in their QFT-GIT results, transitioning from a positive to a negative outcome.
The diagnostic performance of QFT-GIT and QFT-Plus for infection among PLHIV with relatively higher CD4 counts was found to be comparable. Additionally, our investigation revealed that irrespective of the treatment regimen, whether it involved chemotherapy or immunotherapy, preventive infection interventions among PLHIV consistently led to a reduction in IFN-γ levels.
在中国，尚未开展过评估用于HIV感染者（PLHIV）结核感染的全血γ-干扰素释放试验（QFT-GIT）和全血γ-干扰素释放试验升级版（QFT-Plus）的直接比较研究。
在一家监狱医院对PLHIV同时进行QFT-GIT和QFT-Plus检测。比较两种检测方法的阳性和阴性结果，并评估其诊断一致性。
本研究共纳入232例PLHIV个体。其中，分别根据QFT-GIT结果和QFT-Plus诊断出57例患者（24.6%）和56例患者（24.1%）感染结核。两种检测方法的总体一致性为98.3%，Cohen's kappa值为0.954。观察到QFT-GIT plus、QFT-Plus TB1和TB2与QFT-GIT的一致性率分别为98.3%、97.4%和97.8%。发现QFT-GIT检测中测得的IFN-γ水平超过QFT-Plus TB1中的水平（P = 0.04），而与QFT-Plus TB2相比差异呈边缘趋势（P = 0.134）。在接受两次QFT-GIT检测的52例个体亚组中，有23.1%（12例个体）的QFT-GIT结果发生了显著变化，从阳性转变为阴性。
发现QFT-GIT和QFT-Plus对CD4计数相对较高的PLHIV结核感染的诊断性能相当。此外，我们的调查显示，无论治疗方案是化疗还是免疫治疗，PLHIV中的预防性结核感染干预措施均能持续降低IFN-γ水平。
