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. 2011 Sep 30:11:264.
doi: 10.1186/1471-2334-11-264.

Diagnosis of latent tuberculosis infection among HIV discordant partners using interferon gamma release assays

Naasha J Talati  1 , Esteban Gonzalez-Diaz, Charles Mutemba, Joyanna Wendt, William Kilembe, Lawrence Mwananyanda, Elwyn Chomba, Susan Allen, Carlos del Rio, Henry M Blumberg
Affiliations

Diagnosis of latent tuberculosis infection among HIV discordant partners using interferon gamma release assays

Naasha J Talati et al. BMC Infect Dis. .

Abstract

Background: There is limited data on the effect of HIV status and CD4 counts on performance of Interferon-g Release assays (IGRAs) for diagnosis of latent tuberculosis infection (LTBI).

Methods: A cross sectional study was conducted to assess the prevalence of and risk factors for a positive diagnostic test for LTBI, using tuberculin skin test (TST) and IGRAs among HIV-discordant couples in Zambia.

Results: A total of 596 subjects (298 couples) were enrolled. Median CD4 count among HIV positive persons was 388 cells/μl, (range 51-1330). HIV negative persons were more likely than their HIV positive partner, to have a positive diagnostic test for LTBI with TST (203 vs 128), QFT (171 vs 109) and TSPOT (156 vs. 109). On multivariate analysis, HIV negative status was an independent predictor for a positive QFT (OR = 2.22, 95% CI 1.42- 3.46) and TSPOT (OR = 1.79, 95% CI 1.16-2.77). Among HIV positive subjects a CD4 count ≥ 388 cells/μl was associated with a positive TST (OR = 1.76 95% CI 1.10-2.82) and QFT (OR = 1.71 95% CI 1.06-2.77) but not TSPOT (OR = 1.20 95% CI 0.74-1.94).

Conclusions: Persons with HIV had significantly fewer positive diagnostic tests for LTBI with TST, QFT and TSPOT. Persons with a CD4 count < 388 cells/μl were less likely to have a positive TST or QFT, but not less likely to have a positive TSPOT. TSPOT may perform better than TST or QFT in HIV positive individuals.

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Figures

Figure 1
Figure 1
Enrollment of Study Subjects from ZEHRP Cohort.
Figure 2
Figure 2
Positive diagnostic test for latent tuberculosis infection stratified by CD4 count (n = 298).
See this image and copyright information in PMC

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