Walter Dehority1, Rolando M Viani, Maria Rosario G Araneta, Graciano Lopez, Stephen A Spector. 1. From the *Department of Pediatrics, Division of Infectious Diseases, the University of New Mexico Health Sciences Center, †Department of Pediatrics, Division of Infectious Diseases, Center for AIDS Research, Rady Children's Hospital-San Diego, ‡Department of Family and Preventive Medicine, the University of California San Diego School of Medicine, and §Department of Pediatrics, Tijuana General Hospital, Tijuana, Mexico.
Abstract
BACKGROUND: Diagnosis of latent tuberculosis infection (LTBI) is facilitated by tuberculin skin testing (TST) or interferon-gamma release assays such as the QuantiFERON TB Gold In-Tube (QTF-GIT) assays. Limited data exist on the utility of interferon-gamma release assays in HIV-infected children, which may be falsely negative due to immunosuppression. METHODS: A cross-sectional study comparing TST to QTF-GIT for the diagnosis of suspected LTBI was performed in children in Tijuana, Mexico, and in San Diego, California. Concordance between TST (≥5 mm for HIV infected and ≥10 mm for HIV uninfected) and QTF-GIT was evaluated utilizing kappa coefficients. Multivariate logistic regression assessed factors influencing the results. RESULTS: One hundred sixty-five children (70 HIV infected and 95 HIV uninfected) were evaluated (median age, 8.0 years). Among HIV-infected children, the median CD4 cell count was 913 cells/μL, with 92.9% of subjects on antiretroviral treatment and 80.0% with an HIV RNA load <400 copies/mL (76% <50 copies/mL). Among HIV-infected children with no history of tuberculosis, 12 HIV had either a positive QTF-GIT or TST ≥ 5 mm or both, giving a suspected LTBI prevalence of 20.3% (compared with 61.3% among HIV-uninfected children). Moderate concordance was demonstrated in HIV-infected children (both tests positive, κ = 0.42; 95% confidence interval: 8.9%-75.4%) and HIV-uninfected children (both tests positive, κ = 0.59; 95% confidence interval: 43.0%-76.5%). CONCLUSIONS: A moderate correlation exists between TST and QTF-GIT among HIV-infected and uninfected children with preserved immune function in an area of moderate tuberculosis endemicity.
BACKGROUND: Diagnosis of latent tuberculosis infection (LTBI) is facilitated by tuberculin skin testing (TST) or interferon-gamma release assays such as the QuantiFERON TB Gold In-Tube (QTF-GIT) assays. Limited data exist on the utility of interferon-gamma release assays in HIV-infectedchildren, which may be falsely negative due to immunosuppression. METHODS: A cross-sectional study comparing TST to QTF-GIT for the diagnosis of suspected LTBI was performed in children in Tijuana, Mexico, and in San Diego, California. Concordance between TST (≥5 mm for HIV infected and ≥10 mm for HIV uninfected) and QTF-GIT was evaluated utilizing kappa coefficients. Multivariate logistic regression assessed factors influencing the results. RESULTS: One hundred sixty-five children (70 HIV infected and 95 HIV uninfected) were evaluated (median age, 8.0 years). Among HIV-infectedchildren, the median CD4 cell count was 913 cells/μL, with 92.9% of subjects on antiretroviral treatment and 80.0% with an HIV RNA load <400 copies/mL (76% <50 copies/mL). Among HIV-infectedchildren with no history of tuberculosis, 12 HIV had either a positive QTF-GIT or TST ≥ 5 mm or both, giving a suspected LTBI prevalence of 20.3% (compared with 61.3% among HIV-uninfectedchildren). Moderate concordance was demonstrated in HIV-infectedchildren (both tests positive, κ = 0.42; 95% confidence interval: 8.9%-75.4%) and HIV-uninfectedchildren (both tests positive, κ = 0.59; 95% confidence interval: 43.0%-76.5%). CONCLUSIONS: A moderate correlation exists between TST and QTF-GIT among HIV-infected and uninfected children with preserved immune function in an area of moderate tuberculosis endemicity.
Authors: Arturo Plascencia Hernández; Rodrigo M González Sánchez; Iván I Hernández Cañaveral; Antonio Luévanos Velázquez; Pedro A Martínez Arce; Alexander González Díaz; Manuel Sandoval Díaz; Yaxsier de Armas Rodríguez; Edilberto González Ochoa; Héctor Raúl Pérez Gómez Journal: PLoS One Date: 2022-03-10 Impact factor: 3.240