title: Pairing QuantiFERON gold in-tube with opt-out HIV testing in a tuberculosis contact investigation in the Southeastern United States.
abstract: Knowing one's HIV status is particularly important in the setting of recent tuberculosis (TB) exposure. Blood tests for assessment of tuberculosis infection, such as the QuantiFERON Gold in-tube test (QFT; Cellestis Limited, Carnegie, Victoria, Australia), offer the possibility of simultaneous screening for TB and HIV with a single blood draw. We performed a cross-sectional analysis of all contacts to a highly infectious TB case in a large meatpacking factory. Twenty-two percent were foreign-born and 73% were black. Contacts were tested with both tuberculin skin testing (TST) and QFT. HIV testing was offered on an opt-out basis. Persons with TST >or=10 mm, positive QFT, and/or positive HIV test were offered latent TB treatment. Three hundred twenty-six contacts were screened: TST results were available for 266 people and an additional 24 reported a prior positive TST for a total of 290 persons with any TST result (89.0%). Adequate QFT specimens were obtained for 312 (95.7%) of persons. Thirty-two persons had QFT results but did not return for TST reading. Twenty-two percent met the criteria for latent TB infection. Eighty-eight percent accepted HIV testing. Two (0.7%) were HIV seropositive; both individuals were already aware of their HIV status, but one had stopped care a year previously. None of the HIV-seropositive persons had latent TB, but all were offered latent TB treatment per standard guidelines. This demonstrates that opt-out HIV testing combined with QFT in a large TB contact investigation was feasible and useful. HIV testing was also widely accepted. Pairing QFT with opt-out HIV testing should be strongly considered when possible.
authors: Division of Infectious Diseases, Department of Medicine, Duke University Medical Center, Durham, North Carolina 27710, USA. perso006@mc.duke.edu
authors: Anna K
authors: AK
authors: Person
authors: Neela D
authors: ND
authors: Goswami
authors: Deborah J
authors: DJ
authors: Bissette
authors: Debra S
authors: DS
authors: Turner
authors: Ann V
authors: AV
authors: Baker
authors: L Beth
authors: LB
authors: Gadkowski
authors: Susanna
authors: S
authors: Naggie
authors: Kirby
authors: K
authors: Erlandson
authors: Luke
authors: L
authors: Chen
authors: Tahaniyat
authors: T
authors: Lalani
authors: Gary M
authors: GM
authors: Cox
authors: Jason E
authors: JE
authors: Stout
mesh_terms: D000328:Adult; D000368:Aged; D016358:Contact Tracing; D003430:Cross-Sectional Studies; D005260:Female; D015483:HIV Antibodies / Q000097:blood; D015658:HIV Infections / Q000150:complications / Q000175:diagnosis*; D006801:Humans; D007371:Interferon-gamma / Q000097:blood*; D008297:Male; D008875:Middle Aged; D009169:Mycobacterium tuberculosis / Q000276:immunology; D012189:Retrospective Studies; D015144:Southeastern United States / Q000453:epidemiology; D014374:Tuberculin Test / Q000379:methods; D014397:Tuberculosis, Pulmonary / Q000150:complications / Q000175:diagnosis* / Q000453:epidemiology / Q000635:transmission*; D019562:Viral Load; D055815:Young Adult
chemical_list: D015483:HIV Antibodies; D007371:Interferon-gamma