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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
Role of interferon-gamma release assays in the diagnosis of pulmonary tuberculosis in patients with advanced HIV infection
BMC Infectious Diseases, Volume 10, Article 75, Year 2010
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Description
Background: T-cell interferon-gamma release assays (IGRAs) may have a role in the diagnosis of active tuberculosis when evaluating patients for whom standard microbiology has limited sensitivity. Our objective was to examine the accuracy of a commercial IGRA for diagnosis of active tuberculosis in HIV-infected persons.Methods: We enrolled HIV-infected patients admitted to Mulago Hospital in Kampala, Uganda with cough ≥ 2 weeks. All patients underwent standard medical evaluation. We collected peripheral blood specimens at enrollment and performed a commercial, ELISPOT-based IGRA according to the manufacturer's recommendations. IGRA sensitivity and specificity were determined using mycobacterial culture results as the reference standard.Results: Overall, 236 patients were enrolled. The median CD4+ T-lymphocyte count was 49 cells/μl and 126 (53%) patients were diagnosed with active pulmonary tuberculosis. IGRAs were not performed in 24 (10%) patients due to insufficient mononuclear cell counts. In the remaining 212 patients, results were indeterminate in 54 (25%). IGRAs were positive in 95 of 158 (60%) patients with interpretable results. The proportion of positive test results was similar across CD4+ count strata. IGRA sensitivity was 73% and specificity 54%. IGRA results did not meaningfully alter the probability of active tuberculosis in patients with negative sputum smears.Conclusions: An ELISPOT-based IGRA detected a high prevalence of latent tuberculosis infection in a hospitalized population of tuberculosis suspects with advanced HIV/AIDS but had limited utility for diagnosis of active tuberculosis in a high prevalence setting. Further research is needed to identify stronger and more specific immune responses in patients with active tuberculosis. © 2010 Cattamanchi et al; licensee BioMed Central Ltd.
Authors & Co-Authors
Cattamanchi, Adithya
United States, San Francisco
University of California, San Francisco
Ssewanyana, Isaac
Uganda, Kampala
Joint Clinical Research Center Uganda
Davis, J. Lucian
United States, San Francisco
University of California, San Francisco
Huang, Laurence
United States, San Francisco
University of California, San Francisco
Worodria, William O.
Uganda, Kampala
Makerere University
den Boon, Saskia
Uganda, Kampala
Makerere University
Yoo, Samuel D.
Uganda, Kampala
Makerere University
Andama, Alfred Onubia
Uganda, Kampala
Makerere University
Hopewell, Philip C.
United States, San Francisco
University of California, San Francisco
Cao, Huyen L.
United States, Richmond
California Department of Public Health
Statistics
Citations: 40
Authors: 10
Affiliations: 4
Identifiers
Doi:
10.1186/1471-2334-10-75
e-ISSN:
14712334
Research Areas
Health System And Policy
Infectious Diseases
Study Design
Cross Sectional Study
Study Locations
Uganda