There is limited data on the effect of HIV status and CD4 counts on performance of Interferon-g Release assays (IGRAs) for diagnosis of latent tuberculosis infection (LTBI).
A cross sectional study was conducted to assess the prevalence of and risk factors for a positive diagnostic test for LTBI, using tuberculin skin test (TST) and IGRAs among HIV-discordant couples in Zambia.
A total of 596 subjects (298couples) were enrolled. Median CD4 count among HIV positive persons was 388 cells/ μl, (range 51-1330). HIV negative persons were more likely than their HIV positive partner, to have a positive diagnostic test for LTBI with TST (203 vs 128), QFT (171 vs 109) and TSPOT (156 vs. 109). On multivariate analysis, HIV negative status was an independent predictor for a positive QFT (OR=2.22, 95% CI 1.42- 3.46) and TSPOT (OR=1.79, 95% CI 1.16-2.77). Among HIV positive subjects a CD4 count >388cells/µl was associated with a positive TST (OR= 1.76 95% CI 1.10-2.82) and QFT (OR=1.71 95% CI 1.06-2.77) but not TSPOT (OR =1.20 95% CI 0.74-1.94).
Persons with HIV had significantly fewer positive diagnostic tests for LTBI with TST, QFT and TSPOT. Persons with a CD4 count <388 cells/µl were less likely to have a positive TST or QFT, but not less likely to have a positive TSPOT. TSPOT may perform better than TST or QFT in HIV positive individuals.
Table of Contents
TABLE OF CONTENTS
Sample size calculation...7
Discussion and Conclusions...13
About this Master's Thesis
|Committee Chair / Thesis Advisor|
|Diagnosis of Latent Tuberculosis Infection among HIV discordant partners using Interferon-Gamma Release Assays (IGRAs). ()||2018-08-28||