Effect of HIV-infection on QuantiFERON-plus accuracy in patients with active tuberculosis and latent infection

E. Petruccioli, T. Chiacchio, A. Navarra, V. Vanini, G. Cuzzi, C. Cimaglia, L. R. Codecasa, C. Pinnetti, N. Riccardi, F. Palmieri, A. Antinori, D. Goletti

Research output: Contribution to journalArticlepeer-review

Abstract

OBJECTIVE: HIV-infection increases the risk to progress to active-tuberculosis (TB). Detection of latent TB infection (LTBI) is needed to eventually propose preventive-therapy and reduce TB reservoir. QuantiFERON-TB Plus (QFT-Plus)-test identifies LTBI. Currently, only two studies on QFT-Plus accuracy in HIV-infected-population are available in high TB-endemic-countries. Therefore we aimed to evaluate the effect of HIV-infection on QFT-Plus accuracy to detect LTBI in a low TB-endemic-country. METHODS: We enrolled 465 participants, among the 167 HIV-infected-persons: 32 with active-TB (HIV-TB), 45 remote-LTBI (HIV-LTBI) and 90 at low M. tuberculosis (Mtb)-infection risk. Among the 298 HIV-uninfected-persons: 170 with active-TB, 76 recent-LTBI, 34 remote-LTBI and 18 with low Mtb-infection risk. RESULTS: QFT-Plus sensitivity was similar in TB regardless of HIV-status. CD4-count did not influence the distribution of IFN-γ values in HIV-TB and HIV-LTBI. Moreover HIV-LTBI and HIV-uninfected remote LTBI had a similar proportion of results in the uncertain range (IFNγ ≥0.2 ≤ 0.7 IU/ml) differently from those LTBI-persons reporting recent-exposure (p = 0.016). Cytometry results demonstrated that CD8-response was similar in HIV-infected- and -uninfected-persons whereas CD4-response was impaired in HIV-infected-persons (p = 0.011). CONCLUSIONS: HIV-infection does not affect QFT-Plus response in active-TB, whereas the time of exposure influences the proportion of uncertain-results in LTBI.
Original languageEnglish
Pages (from-to)536-546
Number of pages11
JournalJ. Infect.
Volume80
Issue number5
DOIs
Publication statusE-pub ahead of print - Feb 22 2020

Keywords

  • *Hiv *Igra *Latent tuberculosis *M.tuberculosis *QuantiFERON-TB Gold Plus international meetings by Qiagen and Diasorin.

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