Abstract
Rationale: Although interferon (IFN)-γ release assays are approved for the diagnosis of latent tuberculosis infection (LTBI), limited data exist regarding their performance in HIV infection. Objectives: To compare tuberculin skin test (TST) results to the commercial IFN-γ release assay QuantiFERON-TB Gold In-Tube (QFT) for the diagnosis of LTBI in HIV-infected adults. Methods: A total of 294 HIV-infected subjects sampled from two San Francisco cohorts underwent TST, using 5 TU of purified protein derivative, and QFT, measuring IFN-γ response to Mycobacterium tuberculosis-specific RD-1 antigens. Main Results: Of 294 participants, 205 (70%) returned for an evaluable TST. Concordance between QFT and TST was 89.3% (kappa = 0.37, p = 0.007). However, in subjects with positive test results by either TST or QFT, only 28% (8/29) had positive test results by both modalities. TST-positive/QFT-negative discordant results were found in 5.1% of subjects and TST-negative/QFT-positive discordance in 5.6%. Indeterminate QFT results occurred in 5.1%, all due to a failure to respond to the phytohemagglutinin-positive control. Subjects with a CD4+ count of less than 100 cells/mm3 had a relative risk of an indeterminate result of 4.24 (95% confidence interval, 1.55-11.61; p= 0.003) compared with those with a CD4+ count of 100 or more. Conclusions: Overall concordance between QFT and TST in HIV infection was high, but agreement among subjects with positive tests by either modality was low.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 737-742 |
| Number of pages | 6 |
| Journal | American Journal of Respiratory and Critical Care Medicine |
| Volume | 175 |
| Issue number | 7 |
| DOIs | |
| State | Published - Apr 1 2007 |
| Externally published | Yes |
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Keywords
- Human immunodeficiency virus
- Interferon-γ assay
- Latent tuberculosis infection
- QuantiFERON
- Tuberculin skin test
ASJC Scopus subject areas
- Pulmonary and Respiratory Medicine
Cite this
Comparison of an interferon-γ release assay with tuberculin skin testing in HIV-infected individuals. / Luetkemeyer, Annie F.; Charlebois, Edwin D.; Flores, Laura L.; Bangsberg, David; Deeks, Steven G.; Martin, Jeffrey N.; Havlir, Diane V.
In: American Journal of Respiratory and Critical Care Medicine, Vol. 175, No. 7, 01.04.2007, p. 737-742.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Comparison of an interferon-γ release assay with tuberculin skin testing in HIV-infected individuals
AU - Luetkemeyer, Annie F.
AU - Charlebois, Edwin D.
AU - Flores, Laura L.
AU - Bangsberg, David
AU - Deeks, Steven G.
AU - Martin, Jeffrey N.
AU - Havlir, Diane V.
PY - 2007/4/1
Y1 - 2007/4/1
N2 - Rationale: Although interferon (IFN)-γ release assays are approved for the diagnosis of latent tuberculosis infection (LTBI), limited data exist regarding their performance in HIV infection. Objectives: To compare tuberculin skin test (TST) results to the commercial IFN-γ release assay QuantiFERON-TB Gold In-Tube (QFT) for the diagnosis of LTBI in HIV-infected adults. Methods: A total of 294 HIV-infected subjects sampled from two San Francisco cohorts underwent TST, using 5 TU of purified protein derivative, and QFT, measuring IFN-γ response to Mycobacterium tuberculosis-specific RD-1 antigens. Main Results: Of 294 participants, 205 (70%) returned for an evaluable TST. Concordance between QFT and TST was 89.3% (kappa = 0.37, p = 0.007). However, in subjects with positive test results by either TST or QFT, only 28% (8/29) had positive test results by both modalities. TST-positive/QFT-negative discordant results were found in 5.1% of subjects and TST-negative/QFT-positive discordance in 5.6%. Indeterminate QFT results occurred in 5.1%, all due to a failure to respond to the phytohemagglutinin-positive control. Subjects with a CD4+ count of less than 100 cells/mm3 had a relative risk of an indeterminate result of 4.24 (95% confidence interval, 1.55-11.61; p= 0.003) compared with those with a CD4+ count of 100 or more. Conclusions: Overall concordance between QFT and TST in HIV infection was high, but agreement among subjects with positive tests by either modality was low.
AB - Rationale: Although interferon (IFN)-γ release assays are approved for the diagnosis of latent tuberculosis infection (LTBI), limited data exist regarding their performance in HIV infection. Objectives: To compare tuberculin skin test (TST) results to the commercial IFN-γ release assay QuantiFERON-TB Gold In-Tube (QFT) for the diagnosis of LTBI in HIV-infected adults. Methods: A total of 294 HIV-infected subjects sampled from two San Francisco cohorts underwent TST, using 5 TU of purified protein derivative, and QFT, measuring IFN-γ response to Mycobacterium tuberculosis-specific RD-1 antigens. Main Results: Of 294 participants, 205 (70%) returned for an evaluable TST. Concordance between QFT and TST was 89.3% (kappa = 0.37, p = 0.007). However, in subjects with positive test results by either TST or QFT, only 28% (8/29) had positive test results by both modalities. TST-positive/QFT-negative discordant results were found in 5.1% of subjects and TST-negative/QFT-positive discordance in 5.6%. Indeterminate QFT results occurred in 5.1%, all due to a failure to respond to the phytohemagglutinin-positive control. Subjects with a CD4+ count of less than 100 cells/mm3 had a relative risk of an indeterminate result of 4.24 (95% confidence interval, 1.55-11.61; p= 0.003) compared with those with a CD4+ count of 100 or more. Conclusions: Overall concordance between QFT and TST in HIV infection was high, but agreement among subjects with positive tests by either modality was low.
KW - Human immunodeficiency virus
KW - Interferon-γ assay
KW - Latent tuberculosis infection
KW - QuantiFERON
KW - Tuberculin skin test
UR - http://www.scopus.com/inward/record.url?scp=34047231078&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=34047231078&partnerID=8YFLogxK
U2 - 10.1164/rccm.200608-1088OC
DO - 10.1164/rccm.200608-1088OC
M3 - Article
C2 - 17218620
AN - SCOPUS:34047231078
VL - 175
SP - 737
EP - 742
JO - American Journal of Respiratory and Critical Care Medicine
JF - American Journal of Respiratory and Critical Care Medicine
SN - 1073-449X
IS - 7
ER -