Journal article
QuantiFERON conversion following tuberculin administration is common in HIV infection and relates to baseline response.
- Abstract:
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Background
HIV-1 infection impairs tuberculosis (TB) specific immune responses affecting the diagnosis of latent TB. We aimed to (1) determine the proportion of HIV-1-infected adults with a negative QuantiFERON®-TB Gold in-tube (QFT-GIT) and Tuberculin skin testing (TST) that convert to QFT-GIT positive following TST, and (2) evaluate the relationship between conversion and baseline QFT-GIT results.
Methods
HIV-1 infected adults being screened for a TB vaccine study in South Africa underwent QFT-GIT followed by TST. As per protocol, QFT-GIT was repeated if randomization was delayed allowing for evaluation of TST boosting in a proportion of participants.
Results
Of the 22 HIV-1 infected, TST and QFT-GIT negative adults (median CD4 477/mm^3 IQR 439–621) who had QFT-GIT repeated after median 62 days (IQR 49–70), 40.9 % (95 % CI 18.6–63.2 %) converted. Converters had a significantly greater increase in the background subtracted TB antigen response (TBAg-Nil–all units IU/mL) following TST, 0.82 (IQR 0.39–1.28) vs 0.03 (IQR−0.05–0.06),p= 0.0001. Those who converted also had a significantly higher baseline TBAg-Nil 0.21(IQR 0.17–0.26) vs 0.02(IQR 0.01–0.07),p= 0.002. Converters did not differ with regard to CD4 count or ART status. ROC analysis showed a baseline cut off of 0.15 correctly classified 86.4 % of converters with 88.9 % sensitivity.
Conclusions
Our findings support the possibility that there are 2 distinct groups in an HIV-1 infected population with negative QFT-GIT and TST; a true negative group and a group showing evidence of a weak Mtb specific immune response that boosts significantly following TST resulting in conversion of the test result that may represent false negatives. Further evaluation of whether a lower cut off may improve sensitivity of QFT-GIT in this population is warranted.
- Publication status:
- Published
- Peer review status:
- Peer reviewed
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(Preview, Version of record, pdf, 485.3KB, Terms of use)
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- Publisher copy:
- 10.1186/s12879-016-1875-6
Authors
- Grant:
- IP.07.32080.002
- Publisher:
- BioMed Central
- Journal:
- BMC Infectious Diseases More from this journal
- Volume:
- 16
- Issue:
- 1
- Pages:
- 545
- Publication date:
- 2016-10-01
- Acceptance date:
- 2016-09-27
- DOI:
- ISSN:
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1471-2334
- Pmid:
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27717329
- Language:
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English
- Keywords:
- Pubs id:
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pubs:652354
- UUID:
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uuid:e06df011-b35e-43b6-be7b-acefffec800a
- Local pid:
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pubs:652354
- Source identifiers:
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652354
- Deposit date:
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2016-10-13
Terms of use
- Copyright holder:
- Esmail et al
- Copyright date:
- 2016
- Notes:
- © 2016 The Author(s).Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated
- Licence:
- CC Attribution (CC BY)
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