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The impact of HIV infection and CD4 cell count on the performance of an interferon gamma release assay in patients with pulmonary tuberculosis

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  1. Assessment of the sublingual microcirculation with the GlycoCheck system: Reproducibility and examination conditions

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  2. Novel functions of the luteinizing hormone/chorionic gonadotropin receptor in prostate cancer cells and patients

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  3. Hepatitis C prevalence in Denmark in 2016-An updated estimate using multiple national registers

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  4. Inflammation, non-endothelial dependent coronary microvascular function and diastolic function-Are they linked?

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  1. CT and MR neuroimaging findings in patients with Lyme neuroborreliosis: A national prospective cohort study

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  2. Renal function in Ethiopian HIV-positive adults on antiretroviral treatment with and without tenofovir

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  3. Do-not-resuscitate orders in patients with community-acquired pneumonia: a retrospective study

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  4. Lyme neuroborreliosis in adults: A nationwide prospective cohort study

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  5. Første tilfælde af Mycobacterium chimaerainfektion relateret til åben thoraxkirurgi i Danmark

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BACKGROUND: The performance of the tuberculosis specific Interferon Gamma Release Assays (IGRAs) has not been sufficiently documented in tuberculosis- and HIV-endemic settings. This study evaluated the sensitivity of the QuantiFERON TB-Gold In-Tube (QFT-IT) in patients with culture confirmed pulmonary tuberculosis (PTB) in a TB- and HIV-endemic population and the effect of HIV-infection and CD4 cell count on test performance. METHODOLOGY/PRINCIPAL FINDINGS: 161 patients with sputum culture confirmed PTB were subjected to HIV- and QFT-IT testing and measurement of CD4 cell count. The QFT-IT was positive in 74% (119/161; 95% CI: 67-81%). Sensitivity was higher in HIV-negative (75/93) than in HIV-positive (44/68) patients (81% vs. 65%, p = 0.02) and increased with CD4 cell count in HIV-positive patients (test for trend p = 0.03). 23 patients (14%) had an indeterminate result and this proportion decreased with increasing CD4 cell count in HIV-positive patients (test for trend p = 0.03). Low CD4 cell count (<300 cells/microl) did not account for all QFT-IT indeterminate nor all negative results. Sensitivity when excluding indeterminate results was 86% (95% CI: 81-92%) and did not differ between HIV-negative and HIV-positive patients (88 vs. 83%, p = 0.39). CONCLUSIONS/SIGNIFICANCE: Sensitivity of the QFT-IT for diagnosing active PTB infection was reasonable when excluding indeterminate results and in HIV-negative patients. However, since the test missed more than 10% of patients, its potential as a rule-out test for active TB disease is limited. Furthermore, test performance is impaired by low CD4 cell count in HIV-positive patients and possibly by other factors as well in both HIV-positive and HIV-negative patients. This might limit the potential of the test in populations where HIV-infection is prevalent.
Original languageEnglish
JournalPLoS One
Volume4
Issue number1
Pages (from-to)e4220
DOIs
Publication statusPublished - 2009

    Research areas

  • Adult, Biochemistry, CD4-Positive T-Lymphocytes, Female, HIV Infections, HIV Seropositivity, Humans, Interferon-gamma, Male, Prevalence, Reagent Kits, Diagnostic, Sensitivity and Specificity, Sputum, Tanzania, Tuberculosis, Pulmonary

ID: 32566252