title: Tuberculosis skin test, but not interferon-γ-releasing assays is affected by BCG vaccination in HIV patients.
abstract: OBJECTIVE
  Of this study was to compare the results of tuberculin skin test (TST) with two interferon-γ releasing-assays (IGRA) in a cohort of HIV positive patients, to analyze impact of prior Bacille-Calmette-Guérin (BCG)-vaccination.
  
  
  METHODS
  Prospective cross sectional study, enrolling only asymptomatic adult HIV infected outpatients from a large German University hospital clinic. All participants were simultaneously tested for latent tuberculosis infection (LTBI) by QuantiFERON-TB Gold, T-SPOT.TB and TST. Only individuals with available definite results (positive/negative, indeterminates excluded) from all three test systems and recalling BCG-vaccination status by interview questionnaire were evaluated.
  
  
  RESULTS
  From 286 study participants, 133 were evaluable; BCG-vaccination history was positive for 18 individuals, and negative for 115. The proportion of individuals with a positive TST was significantly higher for vaccinated (n = 6, 33.3%) than for unvaccinated individuals (n = 13, 11.3%, p = 0.013). There were no significant differences in the proportion of patients with CDC stage C, origin from a TB endemic country or in the CD4 count between the two groups.
  
  
  CONCLUSIONS
  TST but not IGRAs interfered significantly with prior BCG vaccination in a cohort of HIV infected individuals from a low prevalence TB country. Therefore IGRA should preferentially be used for LTBI-testing in BCG-vaccinated adult HIV-patients.
authors.affiliation: Department of Medicine II, Infectious Diseases Unit, Johann Wolfgang Goethe-University Hospital, Theodor Stern Kai 7, 60590 Frankfurt, Germany.
authors.forename: T
authors.initials: T
authors.lastname: Wolf
authors.forename: U
authors.initials: U
authors.lastname: Goetsch
authors.forename: G
authors.initials: G
authors.lastname: Oremek
authors.forename: M
authors.initials: M
authors.lastname: Bickel
authors.forename: P
authors.initials: P
authors.lastname: Khaykin
authors.forename: A
authors.initials: A
authors.lastname: Haberl
authors.forename: O
authors.initials: O
authors.lastname: Bellinger
authors.forename: R
authors.initials: R
authors.lastname: Gottschalk
authors.forename: H R
authors.initials: HR
authors.lastname: Brodt
authors.forename: C
authors.initials: C
authors.lastname: Stephan
mesh_terms: D000328:Adult; D000368:Aged; D001500:BCG Vaccine / Q000008:administration & dosage / Q000276:immunology*; D003430:Cross-Sectional Studies; D005260:Female; D015658:HIV Infections / Q000150:complications*; D006801:Humans; D007371:Interferon-gamma / Q000097:blood*; D059425:Interferon-gamma Release Tests / Q000379:methods*; D007407:Interviews as Topic; D055985:Latent Tuberculosis / Q000097:blood / Q000175:diagnosis* / Q000276:immunology; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011795:Surveys and Questionnaires; D014374:Tuberculin Test / Q000379:methods*; D014611:Vaccination / Q000706:statistics & numerical data*; D055815:Young Adult
chemical_list: D001500:BCG Vaccine; D007371:Interferon-gamma