PMID- 19208218
OWN - NLM
STAT- MEDLINE
DCOM- 20090310
LR  - 20211020
IS  - 1471-2334 (Electronic)
IS  - 1471-2334 (Linking)
VI  - 9
DP  - 2009 Feb 10
TI  - Poor concordance between interferon-gamma release assays and tuberculin skin 
      tests in diagnosis of latent tuberculosis infection among HIV-infected 
      individuals.
PG  - 15
LID - 10.1186/1471-2334-9-15 [doi]
AB  - BACKGROUND: A new generation of diagnostic tests, the interferon-gamma release 
      assays (IGRAs), have been developed for the detection of latent tuberculosis 
      infection (LTBI). Limited data are available on their use in HIV-infected 
      persons. METHODS: A cross-sectional study was carried out at 2 HIV clinics in 
      Atlanta to assess the utility of two IGRA tests (T-SPOT.TB [TSPOT] and 
      QuantiFERON-TB Gold in Tube [QFT-3G]) compared to the tuberculin skin test (TST). 
      RESULTS: 336 HIV-infected persons were enrolled. Median CD4 count was 335 
      cells/microl and median HIV viral load was 400 copies/ml. Overall, 27 patients 
      (8.0%) had at least 1 positive diagnostic test for LTBI: 7 (2.1%) had a positive 
      TST; 9 (2.7%) a positive QFT-3G; and 14 (4.2%) a positive TSPOT. Agreement 
      between the 3 diagnostic tests was poor: TST and TSPOT, [kappa = 0.16, 95% CI 
      (-0.06, 0.39)], TST and QFT-3G [kappa = 0.23, 95% CI (-0.05, 0.51)], QFT-3G and 
      TSPOT [kappa = 0.06, 95% CI (-0.1, 0.2)]. An indeterminate test result occurred 
      among 6 (1.8%) of QFT-3G and 47 (14%) of TSPOT tests. In multivariate analysis, 
      patients with a CD4 < or = 200 cells/microl were significantly more likely to 
      have an indeterminate result [OR = 3.6, 95% CI (1.9, 6.8)]. CONCLUSION: We found 
      a low prevalence of LTBI and poor concordance between all 3 diagnostic tests. 
      Indeterminate test results were more likely at CD4 counts < or = 200 
      cells/microl. Additional studies among HIV-infected populations with a high 
      prevalence of TB are needed to further assess the utility of IGRAs in this 
      patient population.
FAU - Talati, Naasha J
AU  - Talati NJ
AD  - Division of Infectious Diseases, Emory University, School of Medicine, Atlanta, 
      GA, USA. naashatalati@yahoo.com
FAU - Seybold, Ulrich
AU  - Seybold U
FAU - Humphrey, Bianca
AU  - Humphrey B
FAU - Aina, Abiola
AU  - Aina A
FAU - Tapia, Jane
AU  - Tapia J
FAU - Weinfurter, Paul
AU  - Weinfurter P
FAU - Albalak, Rachel
AU  - Albalak R
FAU - Blumberg, Henry M
AU  - Blumberg HM
LA  - eng
GR  - UL1 TR000454/TR/NCATS NIH HHS/United States
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PT  - Research Support, U.S. Gov't, P.H.S.
DEP - 20090210
PL  - England
TA  - BMC Infect Dis
JT  - BMC infectious diseases
JID - 100968551
RN  - 82115-62-6 (Interferon-gamma)
SB  - IM
MH  - Adult
MH  - Aged
MH  - Cross-Sectional Studies
MH  - Diagnostic Tests, Routine/*standards
MH  - Female
MH  - Georgia
MH  - HIV Infections/*complications
MH  - Humans
MH  - Interferon-gamma/*analysis
MH  - Male
MH  - Middle Aged
MH  - Multivariate Analysis
MH  - Prevalence
MH  - Risk Factors
MH  - Tuberculin Test/standards
MH  - Tuberculosis/*complications/*diagnosis/epidemiology
MH  - Young Adult
PMC - PMC2649136
EDAT- 2009/02/12 09:00
MHDA- 2009/03/11 09:00
PMCR- 2009/02/10
CRDT- 2009/02/12 09:00
PHST- 2008/06/01 00:00 [received]
PHST- 2009/02/10 00:00 [accepted]
PHST- 2009/02/12 09:00 [entrez]
PHST- 2009/02/12 09:00 [pubmed]
PHST- 2009/03/11 09:00 [medline]
PHST- 2009/02/10 00:00 [pmc-release]
AID - 1471-2334-9-15 [pii]
AID - 10.1186/1471-2334-9-15 [doi]
PST - epublish
SO  - BMC Infect Dis. 2009 Feb 10;9:15. doi: 10.1186/1471-2334-9-15.