QuantiFERON®-TB gold in-tube is not Useful for Diagnosing Active Tuberculosis in HIV/AIDS Patients with Severe Immunodeficiency: Results from Brazil
- *Corresponding Author:
- Giselle Burlamaqui Klautau
rua João Ramalho nº 586/191-B
Perdizes, CEP: 05008001
São Paulo, Brazil
E-mail: [email protected]
Received Date: August 18, 2014; Accepted Date: October 20, 2014; Published Date: October 23, 2014
Citation: Klautau GB, Bammann RH, Ferreira NVS, Afiune JB, Burattini MN, et al. (2014) QuantiFERON®-TB gold in-tube is not Useful for Diagnosing Active Tuberculosis in HIV/AIDS Patients with Severe Immunodeficiency: Results from Brazil. J Trop Dis 2:150. doi:10.4172/2329-891X.1000150
Copyright: © 2014 Klautau GB, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Purpose: To assess interferon gamma release assay (IGRA) and tuberculin skin test (TST) performances in the diagnosis of active tuberculosis (TB) in adults with HIV/AIDS with different degrees of immunodeficiency.
Methods: Cross-sectional study conducted with 90 HIV/TB-coinfected adults, São Paulo, Brazil. TB diagnosis was established based on the presence of positive sputum smear, culture, or anatomic-pathological examination. The participants responded to a questionnaire and were submitted to physical examination, chest x-ray (CRX), serum CD4+ and CD8+ T cell count, TST, and IGRA (QuantiFERON®-TB Gold In Tube, Cellestis, Carnegie, Australia).
Results: Characteristics of 90 HIV/TB-coinfected individuals: male (60.0%), white (54.4%), single (57.3%), and average age 39 (±10.8) years with pulmonary TB (45.6%) and average CD4+ T-cell count (198.92 cells/mm3). TST was positive in 25.56%, and IGRA was positive in 65.56%. IGRA performance was better when compared to TST (p<0.001) and was able to diagnose TB with 93.75% probability when CD4+ ≥ 187 cells/mm3 ; TST showed similar efficacy when CD4+ ≥ 500 cells/mm3 .
Conclusion: IGRA exhibited better performance for TB disease diagnosis in HIV-infected individuals with severe immunodeficiency when compared to TST. Nevertheless, both tests may exhibit false-negative results in this type of population. Despite the fact that IGRA has better performance than TST in the diagnosis of active TB in patients with HIV/AIDS, the practical utilization of the method seems to be limited and should be considered only for patients with CD4+ ≥ 187 cells/mm3.