QuantiFERON conversion following tuberculin administration is common in HIV infection and relates to baseline response

 

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dc.contributor.author Esmail, Hanif
dc.contributor.author Thienemann, Friedrich
dc.contributor.author Oni, Tolu
dc.contributor.author Goliath, Rene
dc.contributor.author Wilkinson, Katalin A
dc.contributor.author Wilkinson, Robert J
dc.date.accessioned 2016-11-03T06:37:53Z
dc.date.available 2016-11-03T06:37:53Z
dc.date.issued 2016-10-07
dc.identifier.citation Esmail, H., Thienemann, F., Oni, T., Goliath, R., Wilkinson, K. A., & Wilkinson, R. J. (2016). QuantiFERON conversion following tuberculin administration is common in HIV infection and relates to baseline response. BMC Infectious Diseases, 16(1), 545. en_ZA
dc.identifier.issn 1471-2334 en_ZA
dc.identifier.uri http://dx.doi.org/10.1186/s12879-016-1875-6
dc.identifier.uri http://hdl.handle.net/11427/22419
dc.description.abstract Background: HIV-1 infection impairs tuberculosis (TB) specific immune responses affecting the diagnosis of latent TB. We aimed to (1) determine the proportion of HIV-1-infected adults with a negative QuantiFERON®-TB Gold in-tube (QFT-GIT) and Tuberculin skin testing (TST) that convert to QFT-GIT positive following TST, and (2) evaluate the relationship between conversion and baseline QFT-GIT results. Methods: HIV-1 infected adults being screened for a TB vaccine study in South Africa underwent QFT-GIT followed by TST. As per protocol, QFT-GIT was repeated if randomization was delayed allowing for evaluation of TST boosting in a proportion of participants. Results: Of the 22 HIV-1 infected, TST and QFT-GIT negative adults (median CD4 477/mm3 IQR 439–621) who had QFT-GIT repeated after median 62 days (IQR 49–70), 40.9 % (95 % CI 18.6–63.2 %) converted. Converters had a significantly greater increase in the background subtracted TB antigen response (TBAg-Nil – all units IU/mL) following TST, 0.82 (IQR 0.39–1.28) vs 0.03 (IQR −0.05–0.06), p = 0.0001. Those who converted also had a significantly higher baseline TBAg-Nil 0.21(IQR 0.17–0.26) vs 0.02(IQR 0.01–0.07), p = 0.002. Converters did not differ with regard to CD4 count or ART status. ROC analysis showed a baseline cut off of 0.15 correctly classified 86.4 % of converters with 88.9 % sensitivity. Conclusions: Our findings support the possibility that there are 2 distinct groups in an HIV-1 infected population with negative QFT-GIT and TST; a true negative group and a group showing evidence of a weak Mtb specific immune response that boosts significantly following TST resulting in conversion of the test result that may represent false negatives. Further evaluation of whether a lower cut off may improve sensitivity of QFT-GIT in this population is warranted. en_ZA
dc.language eng en_ZA
dc.publisher BioMed Central en_ZA
dc.rights Creative Commons Attribution 4.0 International (CC BY 4.0) *
dc.rights.uri http://creativecommons.org/licenses/by/4.0/ en_ZA
dc.source BMC Infectious Diseases en_ZA
dc.source.uri http://bmcinfectdis.biomedcentral.com/
dc.subject.other Latent tuberculosis
dc.subject.other HIV
dc.subject.other QuantiFERON®-TB Gold in-tube
dc.subject.other Diagnostics
dc.subject.other Interferon Gamma Release Assay
dc.title QuantiFERON conversion following tuberculin administration is common in HIV infection and relates to baseline response en_ZA
dc.type Journal Article en_ZA
dc.date.updated 2016-10-07T18:03:05Z
dc.language.rfc3066 en
dc.rights.holder The Author(s).
uct.type.publication Research en_ZA
uct.type.resource Article en_ZA
dc.publisher.institution University of Cape Town
dc.publisher.faculty Faculty of Health Sciences en_ZA
dc.publisher.department Division of Infectious Disease and HIV Med en_ZA
uct.type.filetype Text
uct.type.filetype Image


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