BACKGROUND: Data on the prognostic utility of interferon-gamma release assays (IGRAs) for active tuberculosis (TB) among human immunodeficiency virus 1 (HIV-1) infected individuals are limited. METHODS: Samples from a perinatal cohort of HIV-1-infected women in Kenya, obtained during pregnancy, were tested using T-SPOT®.TB IGRAs to detect Mycobacterium tuberculosis-specific interferon-gamma (IFN-γ) responses. IFN-γ (cut-off values of >0, ≥6 and ≥10 spot-forming cells [SFC]/well) and CD4 cell count (cut-off values of <250 and <350 cells/l) were evaluated to determine sensitivity and specificity using a time-dependent receiver operating characteristic curve and positive predictive value (PPV) using the Kaplan Meier method for future TB within 1 year postpartum. RESULTS: Of 327 women, 9 developed TB within 1 year postpartum (incidence rate 3.5/100 person-years of follow-up, 95%CI 1.66.7). IFN-γ ≥ 6 SFC/well was associated with an optimal trade-off between sensitivity (78%) and specificity (55%) and a PPV of 5.9%. In women with CD4 cell count of <250 cells/μl, the sensitivity and specificity of IFN- 6 SFC/well were respectively 89% and 63%, and the PPV was 19.2%. CONCLUSION: Among HIV-1 infected women, IFN-γ response (≥6 SFC/well) during pregnancy lacked a high PPV for postpartum TB, but had higher sensitivity and PPV among immunosuppressed women (CD4 cell count of <250 cells/μl).
BACKGROUND: Data on the prognostic utility of interferon-gamma release assays (IGRAs) for active tuberculosis (TB) among humanimmunodeficiency virus 1 (HIV-1) infected individuals are limited. METHODS: Samples from a perinatal cohort of HIV-1-infectedwomen in Kenya, obtained during pregnancy, were tested using T-SPOT®.TB IGRAs to detect Mycobacterium tuberculosis-specific interferon-gamma (IFN-γ) responses. IFN-γ (cut-off values of >0, ≥6 and ≥10 spot-forming cells [SFC]/well) and CD4 cell count (cut-off values of <250 and <350 cells/l) were evaluated to determine sensitivity and specificity using a time-dependent receiver operating characteristic curve and positive predictive value (PPV) using the Kaplan Meier method for future TB within 1 year postpartum. RESULTS: Of 327 women, 9 developed TB within 1 year postpartum (incidence rate 3.5/100 person-years of follow-up, 95%CI 1.66.7). IFN-γ ≥ 6 SFC/well was associated with an optimal trade-off between sensitivity (78%) and specificity (55%) and a PPV of 5.9%. In women with CD4 cell count of <250 cells/μl, the sensitivity and specificity of IFN- 6 SFC/well were respectively 89% and 63%, and the PPV was 19.2%. CONCLUSION: Among HIV-1 infectedwomen, IFN-γ response (≥6 SFC/well) during pregnancy lacked a high PPV for postpartum TB, but had higher sensitivity and PPV among immunosuppressed women (CD4 cell count of <250 cells/μl).
Authors: Phelgona A Otieno; Elizabeth R Brown; Dorothy A Mbori-Ngacha; Ruth W Nduati; Carey Farquhar; Elizabeth M Obimbo; Rose K Bosire; Sandy Emery; Julie Overbaugh; Barbra A Richardson; Grace C John-Stewart Journal: J Infect Dis Date: 2006-12-13 Impact factor: 5.226
Authors: Youn Jeong Kim; Sang Il Kim; Yang Ree Kim; Seong Heon Wie; Yeon Joon Park; Moon Won Kang Journal: AIDS Res Hum Retroviruses Date: 2012-04-03 Impact factor: 2.205
Authors: Molebogeng X Rangaka; Katalin A Wilkinson; Judith R Glynn; Daphne Ling; Dick Menzies; Judith Mwansa-Kambafwile; Katherine Fielding; Robert J Wilkinson; Madhukar Pai Journal: Lancet Infect Dis Date: 2011-08-16 Impact factor: 25.071