title: Interferon-gamma release assay versus tuberculin skin test for latent tuberculosis infection among HIV patients in Brazil.
abstract: METHODS
  Patients HIV+ attending in a reference clinic, Southern Brazil.
  
  
  OBJECTIVE
  To compare the interferon-gamma-release assay (IGRA - QuantiFERON(®) TB Gold In-Tube) with the tuberculin skin test (TST - PPD-Rt 23) for latent tuberculosis infection (LTBI) in patients with HIV.
  
  
  METHODS
  Cohort study. Patients were simultaneously submitted to the TST and blood collection for the IGRA.
  
  
  RESULTS
  A total of 140 subjects were included. Nine (6.4%) were IGRA+/TST+, 12 (8.6%) were IGRA+/TST-, 4 (3%) were IGRA-/TST+, and 115 (82%) IGRA-/TST-. There was poor agreement between tests (kappa=0.2), and no correlation between these results and CD4+ T lymphocyte counts. During follow-up, one patient with negative results on both tests died from sepsis, and another with discordant results (IGRA+/TST-) exhibited TST seroconversion. Compared to the TST, IGRA showed a sensitivity and specificity of 69% and 90%, respectively. The IGRA detected 8% more positive results than the TST. All patients were followed up for 2 years.
  
  
  CONCLUSIONS
  The higher accuracy of the IGRA would result in LTBI treatments being administered to patients who would have otherwise been overlooked, decreasing the number of active tuberculosis cases. The long-term survival of HIV carriers requires further evaluation.
authors.affiliation: Internal Medicine and Health Science, Universidade Federal do Paraná, Curitiba, PR, Brazil; Bacteriology Laboratory, Hospital de Clínicas, Universidade Federal do Paraná, Curitiba, PR, Brazil.
authors.forename: Gislene Maria Botão
authors.initials: GM
authors.lastname: Kussen
authors.affiliation: Bacteriology Laboratory, Hospital de Clínicas, Universidade Federal do Paraná, Curitiba, PR, Brazil; Faculdades e Instituto de Pesquisa Pelé Pequeno Príncipe, Curitiba, PR, Brazil.
authors.forename: Libera Maria
authors.initials: LM
authors.lastname: Dalla-Costa
authors.affiliation: Department of Pediatrics, Hospital de Clínicas, Universidade Federal do Paraná, Curitiba, PR, Brazil.
authors.forename: Andrea
authors.initials: A
authors.lastname: Rossoni
authors.affiliation: Internal Medicine and Health Science, Universidade Federal do Paraná, Curitiba, PR, Brazil; Infectious Diseases Division, Universidade Federal do Paraná, Curitiba, PR, Brazil. Electronic address: sraboni@ufpr.br.
authors.forename: Sonia Mara
authors.initials: SM
authors.lastname: Raboni
mesh_terms: D000328:Adult; D015496:CD4-Positive T-Lymphocytes; D015331:Cohort Studies; D005260:Female; D015658:HIV Infections / Q000150:complications*; D006801:Humans; D059425:Interferon-gamma Release Tests; D055985:Latent Tuberculosis / Q000150:complications / Q000175:diagnosis*; D008297:Male; D008875:Middle Aged; D009169:Mycobacterium tuberculosis / Q000276:immunology / Q000302:isolation & purification; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D014374:Tuberculin Test
keywords: Immunocompromised patients; Immunological tests; Mycobacterium tuberculosis