title: Predictive value of interferon-γ ELISPOT assay in HIV 1-infected patients in an intermediate tuberculosis-endemic area.
abstract: The tuberculin skin test for diagnosing latent tuberculosis (TB) has some limitations for HIV-infected patients, especially in BCG vaccinated countries. The objective of this study was to identify the incidence rate of new TB cases among HIV-infected patients in an intermediate TB-endemic area and to examine its correlation with the ELISPOT assay. We prospectively followed up 124 patients with HIV-1 infection to monitor development of active TB disease after performing an ELISPOT assay (T-SPOT. TB test, Oxford Immunotec, Ltd., Abingdon, UK). A total of 120 patients were followed for a median of 947 days; four patients with active TB at enrollment were excluded. Eleven patients developed active TB during 238 person-years, giving a high incidence rate of 4621/100,000 person-years. Patients with positive ELISPOT responses had a higher TB incidence rate than those with negative ELISPOT responses; however this was not statistically significant [20% (6/30) vs. 6.02% (5/83), p=0.052]. A Cox regression analysis showed that the independent risk factors associated with progression of TB were low CD4(+) T cell counts, previous history of TB treatment, and positive ELISPOT results. Advanced HIV-infected patients who showed a positive TB ELISPOT assay had a higher rate of progression to TB in the intermediate TB-endemic area.
authors.affiliation: Division of Infectious Diseases, Department of Internal Medicine, Seoul St. Mary's Hospital, The Catholic University of Korea, Republic of Korea.
authors.forename: Youn Jeong
authors.initials: YJ
authors.lastname: Kim
authors.forename: Sang Il
authors.initials: SI
authors.lastname: Kim
authors.forename: Yang Ree
authors.initials: YR
authors.lastname: Kim
authors.forename: Seong Heon
authors.initials: SH
authors.lastname: Wie
authors.forename: Yeon Joon
authors.initials: YJ
authors.lastname: Park
authors.forename: Moon Won
authors.initials: MW
authors.lastname: Kang
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018791:CD4 Lymphocyte Count; D018450:Disease Progression; D058501:Enzyme-Linked Immunospot Assay; D005260:Female; D006679:HIV Seropositivity / Q000453:epidemiology / Q000276:immunology*; D015497:HIV-1 / Q000276:immunology*; D006801:Humans; D016867:Immunocompromised Host / Q000276:immunology; D007371:Interferon-gamma / Q000494:pharmacology*; D055985:Latent Tuberculosis / Q000453:epidemiology / Q000276:immunology* / Q000517:prevention & control; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D056910:Republic of Korea / Q000453:epidemiology; D018571:Sentinel Surveillance; D014374:Tuberculin Test; D055815:Young Adult
chemical_list: D007371:Interferon-gamma