title: Detection of latent tuberculosis by the tuberculin skin test and a whole-blood interferon-γ release assay, and the development of active tuberculosis in HIV-seropositive persons.
abstract: This study evaluated the QuantiFERON-TB Gold In-Tube (QFT-GIT; Cellestis, Carnegie, Australia) test and the tuberculin skin test (TST) for the detection of latent tuberculosis infection (LTBI) in HIV-infected adults. One hundred thirty-five HIV-seropositive persons and 135 controls underwent TST and QFT-GIT. HIV-infected patients who gave a positive result on either test were offered chemoprophylaxis. The prevalence of LTBI was 6.7% by TST and 9.6% by QFT-GIT (P = 0.3) in HIV-seropositive subjects, and 34.8% by TST and 21.5% by QFT-GIT (P = 0.02) among controls. TST reactivity declined sharply as CD4(+) cells fell (15.8%, 10.3%, and 0% for >500, 301-500 and ≤300 CD4(+) cells/mm(3), respectively; P = 0.002). A less pronounced fall occurred with QFT-GIT (15.8%, 13.8%, and 0% for >500, 301-500, and <100 CD4(+) cells/mm(3), respectively; P = 0.03). No cases of tuberculosis occurred during follow-up (0.26 per 100 person-years). Simultaneous testing with TST and QFT-GIT for targeting of chemoprophylaxis, early in the course of HIV infection, might minimize the risk of tuberculosis in these patients.
authors.affiliation: Department of Infectious Diseases, Bellvitge University Hospital-Institut d'Investigació Biomèdica de Bellvitge (IDIBELL) 08907 Hospitalet de Llobregat, Barcelona, Spain. msantin@bellvitgehospital.cat
authors.forename: Miguel
authors.initials: M
authors.lastname: Santin
authors.forename: Susana
authors.initials: S
authors.lastname: Casas
authors.forename: Maria
authors.initials: M
authors.lastname: Saumoy
authors.forename: Ana
authors.initials: A
authors.lastname: Andreu
authors.forename: Raquel
authors.initials: R
authors.lastname: Moure
authors.forename: Fernando
authors.initials: F
authors.lastname: Alcaide
authors.forename: Elena
authors.initials: E
authors.lastname: Ferrer
authors.forename: Daniel
authors.initials: D
authors.lastname: Podzamczer
mesh_terms: D000328:Adult; D001431:Bacteriological Techniques / Q000379:methods*; D001769:Blood / Q000276:immunology*; D018791:CD4 Lymphocyte Count; D015496:CD4-Positive T-Lymphocytes / Q000276:immunology; D005260:Female; D015658:HIV Infections / Q000150:complications; D006801:Humans; D007371:Interferon-gamma / Q000378:metabolism; D055985:Latent Tuberculosis / Q000175:diagnosis*; D008297:Male; D012680:Sensitivity and Specificity; D012867:Skin / Q000276:immunology*; D014374:Tuberculin Test
chemical_list: D007371:Interferon-gamma