QuantiFERON conversion following tuberculin administration is common in HIV infection and relates to baseline response
| 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.date.updated | 2016-10-07T18:03:05Z | |
| 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.identifier.apacitation | 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. <i>BMC Infectious Diseases</i>, http://hdl.handle.net/11427/22419 | en_ZA |
| dc.identifier.chicagocitation | Esmail, Hanif, Friedrich Thienemann, Tolu Oni, Rene Goliath, Katalin A Wilkinson, and Robert J Wilkinson "QuantiFERON conversion following tuberculin administration is common in HIV infection and relates to baseline response." <i>BMC Infectious Diseases</i> (2016) http://hdl.handle.net/11427/22419 | en_ZA |
| 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.ris | TY - Journal Article AU - Esmail, Hanif AU - Thienemann, Friedrich AU - Oni, Tolu AU - Goliath, Rene AU - Wilkinson, Katalin A AU - Wilkinson, Robert J AB - 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. DA - 2016-10-07 DB - OpenUCT DO - 10.1186/s12879-016-1875-6 DP - University of Cape Town J1 - BMC Infectious Diseases LK - https://open.uct.ac.za PB - University of Cape Town PY - 2016 SM - 1471-2334 T1 - QuantiFERON conversion following tuberculin administration is common in HIV infection and relates to baseline response TI - QuantiFERON conversion following tuberculin administration is common in HIV infection and relates to baseline response UR - http://hdl.handle.net/11427/22419 ER - | 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.identifier.vancouvercitation | Esmail H, Thienemann F, Oni T, Goliath R, Wilkinson KA, Wilkinson RJ. QuantiFERON conversion following tuberculin administration is common in HIV infection and relates to baseline response. BMC Infectious Diseases. 2016; http://hdl.handle.net/11427/22419. | en_ZA |
| dc.language | eng | en_ZA |
| dc.language.rfc3066 | en | |
| dc.publisher | BioMed Central | en_ZA |
| dc.publisher.department | Division of Infectious Disease and HIV Med | en_ZA |
| dc.publisher.faculty | Faculty of Health Sciences | en_ZA |
| dc.publisher.institution | University of Cape Town | |
| dc.rights | Creative Commons Attribution 4.0 International (CC BY 4.0) | * |
| dc.rights.holder | The Author(s). | |
| 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 |
| uct.type.filetype | Text | |
| uct.type.filetype | Image | |
| uct.type.publication | Research | en_ZA |
| uct.type.resource | Article | en_ZA |