scholarly journals Modern possibilities of diagnostics of tuberculosis in patients with HIV infection

2021 ◽  
Vol 69 (1) ◽  
Author(s):  
Alyona Kuznetsova ◽  
◽  
Elena Borodulina ◽  
Keyword(s):  
Hiv Infection ◽  
Positive Result ◽  
Screening Method ◽  
Latent Tuberculosis ◽  
Hiv Infections ◽  
Tuberculosis Infection ◽  
Steady Growth ◽  
Severe Immunodeficiency ◽  
Diagnostic Complex

The problem of the steady growth of HIV-associated tuberculosis has become increasingly urgent in recent years in Russia. Diagnosis of tuberculosis is particularly difficult at the stage of severe immunodeficiency. Objective. to evaluate the effectiveness of the T-SPOT ® method.TB in the diagnosis of tuberculosis infection in patients with HIV infection. Materials and methods. in the period for 2019-2020, the T-SPOT®.TB results were analyzed in 396 patients. The criteria for inclusion in this study were the age of 18 years and older, the diagnosis of HIV infection, follow-up at the AIDS center. Results. in the group with a positive T-SPOT®.TB and changes on the computed tomogram, the verified diagnosis of tuberculosis was 90.7% of the group with both signs and 75.5% of those with a positive result T-SPOT®.TB. The group with a positive result T-SPOT®.TB and no changes on the CT scan is 16.8% of those with a positive result T-SPOT®.TB,such patients were diagnosed with „latent tuberculosis infection”. Conclusion. T-SPOT®.TB can be used in the diagnostic complex of monitoring patients with HIV infections — as a screening method that allows not only to verify the diagnosis, but also to detect latent tuberculosis.

scholarly journals POS1157 CONCORDANCE BETWEEN THE QUANTIFERON-TB GOLD IN-TUBE AND TUBERCULIN TEST FOR THE DIAGNOSIS OF LATENT TUBERCULOSIS INFECTION IN PATIENTS WITH RHEUMATIC DISEASES

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 857.1-857
Author(s):  
C. Pávez Perales ◽  
A. Quiles Roger ◽  
E. Grau García ◽  
M. De la Rubia Navarro ◽  
S. Leal Rodriguez ◽  
...  
Keyword(s):  
Rheumatic Diseases ◽  
Latent Tuberculosis Infection ◽  
Latent Tuberculosis ◽  
Tuberculin Test ◽  
Tuberculosis Infection ◽  
Categorical Variables ◽  
Ltbi Screening ◽  
Kappa Test ◽  
Receive Treatment

Background:Patients with rheumatic diseases (RD) are at higher risk of latent tuberculosis infection (LTBI) reactivation. To detect and treat it before starting treatment, especially with biological therapies, decrease the reactivation risk. Diagnosis is carried out by the tuberculin skin test (TST) or interferon-gamma release assays (IGRAs), IGRAs might be more specific and sensitive.Objectives:We aim to analyze the concordance between QuantiFERON-TB Gold In-Tube (QTF) and TST for the diagnosis of LTBI in patients with rheumatic diseases.Methods:A retrospective observational study was conducted including patients diagnosed with RD screened for LTBI with both TST and QTF (2014-2018). Demographical and clinical variables at screening and at follow-up were collected. The concordance between both tests has been estimated as categorical variables using Cohen´s Kappa test, considering “poor” if it is ≤ 0,20; “low” if 0,20 < k ≤ 0,40, “moderate” if 0,40 < k ≤ 0,60, “substantial” if 0,60 < k ≤ 0,80 and “optimal” if k > 0,80.Results:167 patients were included (57% women) with a mean age of 52±16 years. 42% of them had systemic autoimmune diseases, 22% spondyloarthropathies and 36% other RD. 2 had history of past active tuberculosis (TB). At the time of screening, 46.11% were treated with GC.LTBI was diagnosed in 35 patients: 15 had both QTF and TST positive, 16 only QTF positive and 4 only TST positive. 12 from 31 QTF positive patients were treated with GC at the time of screening. 3 from 19 TST positive patients were treated with GC at the time of screening.After LTBI screening 62 patients received biological treatment, 4 of them had both test positive, 6 only QTF positive and 2 only TST positive. 11 received LTBI treatment according to the hospital protocol (isoniazid for 6 to 9 months). 10 completed treatment, 1 did not because of intolerance and did not receive other treatment. 1 patient with only TST positive was considered a false positive and did not receive treatment. During follow-up no TB reactivation was reported.23 patients with LBTI received treatment other than biological therapy during follow-up, of them 8 received LBTI treatment. There was no TB reactivation during follow up.The Kappa concordance between QTF and TST was estimated: moderated in the whole sample, poor in the patients treated with GC at screening, and substantial when the patients treated with GC at screening were excluded. Results are shown in Table 1.Table 1.Kappa concordance between QTF and TST.Conclusion:QTF seems to be the most appropriate LTBI screening test in patients with RD treated with GC. Screening and treatment of LTBI in patients with RD treated with or without biological agents was effective in reducing TB reactivation.Disclosure of Interests:None declared.

scholarly journals Recombinant in vitro test T-SPOT.TB as a screening method for early diagnosis of tuberculosis infection

2020 ◽  
Vol 98 (4) ◽  
pp. 48-52
Author(s):  
E. P. Eremenko ◽  
E. A. Borodulina ◽  
I. A. Sergeeva ◽  
D. A. Kudlay ◽  
B. E. Borodulin
Keyword(s):  
Screening Method ◽  
Latent Tuberculosis ◽  
Tuberculosis Infection ◽  
Mantoux Test ◽  
Skin Tests ◽  
In Vitro Tests ◽  
In Vitro Test ◽  
Healthy Children ◽  
Vitro Test

In addition to standard skin tests (Mantoux test with 2 TU PPD-L and diaskintest) for the diagnosis of tuberculosis infection, in vitro tests are used. One of these tests is T-SPOT.TB being more widely used in recent years.The objective: to evaluate the effectiveness of T-SPOT.TB test for early detection of tuberculosis infection in children and adolescents in Samara Region.Subjects and methods. From 2016 to 2019, results of T-SPOT.TB tests performed in 596 children aged 2 to 17 years inclusive were analyzed; those children had no immunodiagnosis of tuberculosis infection using skin tests since their parents refused to have it.Results. It was found out that the major reason for refusing skin tests was the “fear” of visiting a TB dispensary if the result had been positive — 38.43% (n = 229). The latent tuberculosis infection according to the results of T-SPOT.TB among children with concomitant pathology made 2.6%, among healthy children – 0.7%.Conclusion. T-SPOT.TB test may be used as an alternative method for diagnosis of tuberculosis infection, should the parent refuse to have skin tests. In children with concomitant pathology, T-SPOT.TB test can serve as a leading method for immunodiagnosis of tuberculosis.The authors state that they have no conflict of interests.

scholarly journals Comparison of Quantiferon-TB Gold and TST tests in the diagnosis of latent tuberculosis infection among HIV infected patients in Hamadan, west of Iran

2020 ◽  
Vol 14 (04) ◽  
pp. 360-365
Author(s):  
Fariba Keramat ◽  
Benyamin Bagheri Delavar ◽  
Alireza Zamani ◽  
Jalal Poorolajal ◽  
Elham Lajevardi ◽  
...  
Keyword(s):  
Hiv Infection ◽  
Latent Tuberculosis Infection ◽  
Demographic Data ◽  
Clinical Manifestations ◽  
Latent Tuberculosis ◽  
Cd4 Count ◽  
Tuberculosis Infection ◽  
Percent Agreement ◽  
Immunodeficiency Virus ◽  
The Mean

Introduction: Human immunodeficiency virus (HIV) infection increases the susceptibility of patients for latent tuberculosis infection (LTBI) and reactivtion tuberculosis. This study aimed to compare the Quantiferon-TB gold-in tube test (QFT) with tuberculin skin test (TST) in the diagnosis of LTBI in HIV infected patients. Methodology: This comparative study of 89 patients with HIV in the Behavioral Diseases Counseling Center in Hamadan was carried out from July 2015 to November 2016. After obtaining consent from the patients, all demographic data, clinical manifestations, and laboratory results (CD4 count, TST and QFT) were entered into the questionnaires. The CD4 count is usually routinely performed using flow cytometry at the Behavioral Counselling Center. Quantiferon-TB test was done by using Qiagen – Quantiferon-2 plate kit ELISA. Results: Totally, 89 HIV infected patients with the mean age of 39.55 ± 10.31 years old were enrolled in the study. Sixty patients (67.42%) were male. The mean duration of HIV infection was 4.44 ± 3.88 years and the mean of CD4 count was 388.65 ± 260.66 cells/µL . Twenty patients had LTBI based on TST. Considering the QFT intermediate results as a positive test, the percent agreement of QFT and TST was 59.55%, which was not statistically significant (P = 0.2387). Conclusions: According to the results, there was no significant percent agreement between QFT and TST for detecting LTBI in HIV infected patients. However, by decreasing CD4 counts, there was a significant relation between TST positive and LTBI in HIV patients.

scholarly journals Randomized Controlled Trial of Interventions to Improve Follow-up for Latent Tuberculosis Infection After Release From Jail

2002 ◽  
Vol 162 (9) ◽  
pp. 1044 ◽  
Author(s):  
Mary Castle White ◽  
Jacqueline P. Tulsky ◽  
Joe Goldenson ◽  
Carmen J. Portillo ◽  
Masae Kawamura ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Latent Tuberculosis Infection ◽  
Controlled Trial ◽  
Latent Tuberculosis ◽  
Tuberculosis Infection ◽  
Randomized Controlled

scholarly journals 1376. Physician Practice Patterns for Screening and Treatment of Latent Tuberculosis Infection in the South Asian Population in Central New Jersey

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S499-S500
Author(s):  
Nupur Gulati ◽  
Sri Ram Pentakota ◽  
Kristina N Feja ◽  
Bishakha Ghoshal ◽  
Rajita Bhavaraju ◽  
...  
Keyword(s):  
New Jersey ◽  
South Asian ◽  
Outcome Measure ◽  
Latent Tuberculosis Infection ◽  
Latent Tuberculosis ◽  
Tuberculosis Infection ◽  
Medical Graduate ◽  
Chi Square ◽  
Ltbi Screening

Abstract Background New Jersey (NJ) has a significant burden of tuberculosis (TB) cases (ranked 8th in the United States) and 22% of the cases are among foreign-born (FB) individuals. We have approximately 33% FB residents in our targeted counties in Central NJ of whom 43% are originally from high TB burden areas of South Asia. Central NJ is home to the county with the second highest TB case rate in NJ. Latent tuberculosis infection (LTBI) treatment remains a key component of the World Health Organization TB elimination strategy. We sought to survey community physicians about their LTBI screening and treatment practices in South Asian (SA) patients. Methods An IRB-approved anonymous survey was distributed online to practicing staff physicians at local hospitals over a 2-month period. The primary outcome measure was whether physicians appropriately screen for LTBI. A secondary outcome measure was whether follow-up after medication initiation was provided. Predictors measured included: age, gender, self -identification of physician as SA, years in practice, and if they were a foreign medical graduate (FMG). Descriptive statistics were provided using counts and proportions. Chi-square tests were used for bivariate analyses to look for factors associated with LTBI screening and treatment. Results A total of 218 physicians responded to the survey; of whom, 137 identified themselves as primary care physicians (i.e., pediatrics (62%), internal medicine (30%), or family medicine (8%)). About half of them were FMG and 40% identify themselves as SA. Three out of four of these physicians (n = 101) indicated they routinely screen their patients for LTBI. Bivariate analyses using chi-square did not find any statistically significant associations with LTBI screening. A quarter of the physicians screened with an IGRA and 60% reported always offering treatment for LTBI. Isoniazid was the most common medication prescribed. A majority of respondents did not report prescribing Rifampin or Rifapentine. Follow-up after initiation of treatment was provided at least every other month by 52.7% of physicians. Conclusion There is wide variability in LTBI screening, treatment, and follow-up among our physician sample. Physicians have not yet adopted newer treatment regimens suggesting the need for an educational intervention. Disclosures All authors: No reported disclosures.

scholarly journals CD4 response of QuantiFERON-TB Gold Plus for positive consistency of latent tuberculosis infection in patients on dialysis

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Ping-Huai Wang ◽  
Shu-Yung Lin ◽  
Susan Shih-Jung Lee ◽  
Shu-Wen Lin ◽  
Chih-Yuan Lee ◽  
...  
Keyword(s):  
Latent Tuberculosis Infection ◽  
Latent Tuberculosis ◽  
Interferon Γ ◽  
Tuberculosis Infection ◽  
Dialysis Patients ◽  
The Difference ◽  
Data Representative

AbstractA significantly negative reversion in the QuantiFERON-TB Gold In-tube (QFT-GIT) test is reported in patients on dialysis, which makes the results unreliable. The CD4 and CD8 responses of the QFT-Gold plus (QFT-Plus) may have better positive consistency, but this needs to be investigated. We enrolled dialysis patients with baseline positive QFT-GIT0 results and conducted two rounds of follow-up paired QFT-GIT1&2 and QFT-Plus1&2 tests at an interval of 6 months. The positive consistency, concordance, and discordance of the QFT results were analyzed. A total of 236 patients on dialysis were screened, and 73 participants with positive QFT-GIT0 results were enrolled. The baseline QFT-GIT0 response was higher in the 1st QFT-Plus1(+) group than in the QFT-Plus1(−) group, but insignificantly different between the 1st QFT-GIT1(+) and QFT-GIT1(−) groups. The two assays had good correlation when concurrently tested. Fifty-three subjects completed a second round of the QFT-GIT2 and QFT-Plus2. Persistent positivity was higher with the QFT-Plus2 (81.8%) than with the QFT-GIT2 (58.8%, p = 0.040). The QFT-GIT1 and QFT-Plus1 CD4 responses were higher in patients with persistent positivity than in those with negative reversion, whereas the difference of the QFT-Plus TB1 and TB2 data, representative of the CD8 response, were similar between positive persistence and negative reversion. In conclusion, the QFT-Plus provides more reliable positive consistency than does the QFT-GIT. The CD4 interferon-γ response might play a role in maintaining positivity of LTBI.

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