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

doi:10.1016/j.jinf.2020.02.009

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

Istituto Sacro Cuore Don Calabria - Negrar

Research output: Contribution to journal › Article › peer-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 language	English
Pages (from-to)	536-546
Number of pages	11
Journal	J. Infect.
Volume	80
Issue number	5
DOIs	https://doi.org/10.1016/j.jinf.2020.02.009
Publication status	E-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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Effect of HIV-infection on QuantiFERON-plus accuracy in patients with active tuberculosis and latent infection. / Petruccioli, E.; Chiacchio, T.; Navarra, A.; Vanini, V.; Cuzzi, G.; Cimaglia, C.; Codecasa, L. R.; Pinnetti, C.; Riccardi, N.; Palmieri, F.; Antinori, A.; Goletti, D.

In: J. Infect., Vol. 80, No. 5, 22.02.2020, p. 536-546.

Research output: Contribution to journal › Article › peer-review

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

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.",

keywords = "*Hiv *Igra *Latent tuberculosis *M.tuberculosis *QuantiFERON-TB Gold Plus international meetings by Qiagen and Diasorin.",

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

note = "1532-2742 Petruccioli, Elisa Chiacchio, Teresa Navarra, Assunta Vanini, Valentina Cuzzi, Gilda Cimaglia, Claudia Codecasa, Luigi Ruffo Pinnetti, Carmela Riccardi, Niccol{\`o} Palmieri, Fabrizio Antinori, Andrea Goletti, Delia R21 AI127133/AI/NIAID NIH HHS/United States Journal Article Research Support, N.I.H., Extramural Research Support, Non-U.S. Gov't England J Infect. 2020 May;80(5):536-546. doi: 10.1016/j.jinf.2020.02.009. Epub 2020 Feb 22.",

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TY - JOUR

T1 - Effect of HIV-infection on QuantiFERON-plus accuracy in patients with active tuberculosis and latent infection

AU - Petruccioli, E.

AU - Chiacchio, T.

AU - Navarra, A.

AU - Vanini, V.

AU - Cuzzi, G.

AU - Cimaglia, C.

AU - Codecasa, L. R.

AU - Pinnetti, C.

AU - Riccardi, N.

AU - Palmieri, F.

AU - Antinori, A.

AU - Goletti, D.

N1 - 1532-2742 Petruccioli, Elisa Chiacchio, Teresa Navarra, Assunta Vanini, Valentina Cuzzi, Gilda Cimaglia, Claudia Codecasa, Luigi Ruffo Pinnetti, Carmela Riccardi, Niccolò Palmieri, Fabrizio Antinori, Andrea Goletti, Delia R21 AI127133/AI/NIAID NIH HHS/United States Journal Article Research Support, N.I.H., Extramural Research Support, Non-U.S. Gov't England J Infect. 2020 May;80(5):536-546. doi: 10.1016/j.jinf.2020.02.009. Epub 2020 Feb 22.

PY - 2020/2/22

Y1 - 2020/2/22

N2 - 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.

AB - 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.

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

U2 - 10.1016/j.jinf.2020.02.009

DO - 10.1016/j.jinf.2020.02.009

M3 - Article

VL - 80

SP - 536

EP - 546

JO - J. Infect.

JF - J. Infect.

SN - 0163-4453

IS - 5

ER -