Role of Interferon Gamma Release Assay in Active TB Diagnosis among HIV Infected Individuals 英文参考文献.docVIP

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Role of Interferon Gamma Release Assay in Active TB Diagnosis among HIV Infected Individuals 英文参考文献.doc

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Role of Interferon Gamma Release Assay in Active TB Diagnosis among HIV Infected Individuals 英文参考文献

RoleofInterferonGammaReleaseAssayinActiveTB DiagnosisamongHIVInfectedIndividuals BasirudeenSyedAhamedKabeer1,RajasekaranSikhamani5,SowmyaSwaminathan2 ,Venkatesan Perumal3,PaulkumaranParamasivam4,AlameluRaja1* 1DepartmentofImmunology,TuberculosisResearchCentre(ICMR),TamilNadu,India,2DivisionofHIV/AIDS,TuberculosisResearchCentre(ICMR),TamilNadu,India, 3Department of Statistics, Tuberculosis Research Centre (ICMR), Tamil Nadu, India, 4Depatment of Clinic, Tuberculosis Research Centre (ICMR), Tamil Nadu, India, 5GovernmentHospitalofThoracicMedicine,TambaramSanatorium,Tambaram,TamilNadu,India Abstract Background: A rapid and specific test is urgently needed for tuberculosis (TB) diagnosis especially among human immunodeficiency virus (HIV) infected individuals. In this study, we assessed the sensitivity of Interferon gamma release assay(IGRA)inactivetuberculosispatientswhowerepositiveforHIVinfectionandcompareditwiththatoftuberculinskin test(TST). Methodology/Principal Findings: Atotal of105HIV-TBpatients who werena?¨veforantituberculosis andantiretroviral therapywereincludedforthisstudyoutofwhich53(50%)wereculturepositive.Of105tested,QuantiFERON-TBGoldin- tube(QFT-G)waspositivein65%(95%CI:56%to74%),negativein18%(95%CI:11%to25%)andindeterminatein17% (95% CI: 10% to 24%) of patients. The sensitivity of QFT-G remained similar in pulmonary TB and extra-pulmonary TB patients. The QFT-G positivity was not affected by low CD4 count, but it often gave indeterminate results especially in individuals with CD4 count ,200 cells/ml. All of the QFT-G indeterminate patients whose sputum culture were positive, showed#0.25IU/mlofIFN-cresponsetophytohemagglutinin(PHA).TSTwasperformedinallthe105patientsandyielded thesensitivityof31%(95%CI:40%to22%).AlltheTSTpositiveswereQFT-Gpositives.ThesensitivityofTSTwasdecreased, whenCD4cellcountsdeclined. Conclusions/Significance: OurstudyshowsneitherQFT-GaloneorincombinationwithTSTcanbeusedtoexcludethe suspicionofactiveTBdisease.However,unlikeTST,Q