Leidl, L. and Mayanja Kizza, Harriet and Sotgiu, Giovanni and Baseke, J. and Ernst, Martin and Hirsch, Christina and Goletti, Delia and Toossi, Zahra and Lange, Christoph (2010) Relationship of immunodiagnostic assays for tuberculosis and numbers of circulating CD4+ T-cells in HIV infection. European Respiratory Journal, Vol. 35 (3), p. 619-626. eISSN 1399-3003. Article.
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Infection with HIV is the greatest risk factor for tuberculosis (TB) in Africa. Tuberculin skin test (TST), QuantiFERON-TB Gold In-Tube (QFT-G-IT) and T-Spot.TB assays were performed in newly diagnosed HIV-infected individuals with and without active TB and in HIV-uninfected subjects at a university outpatient clinic in Kampala, Uganda.
A total of 135 individuals were enrolled: 109 with a new diagnosis of HIV-1 infection but no active TB, 19 with HIV-1 infection and active TB, and seven HIV-uninfected healthy subjects. In control subjects immune responses were positive in 57.2% by TST and in 100% by at least one interferon-γ release assay.
In HIV-1 infected patients without active TB, induration in the TST (mm) (rho = 0.41, p-value <0.0001) and concentration of interferon (IFN)-γ in the QFT-G-IT tube with Mycobacterium tuberculosis-specific antigens (rho = 0.38; p = 0.0001) were negatively correlated to numbers of circulating CD4+ T-cells, while numbers of IFN-γ producing cells (rho = 0.03–0.13; p-value = 0.21–0.77) and frequencies of positive test results for the T-Spot.TB test among groups of patients with different levels of immunodeficiency remained constant (p-value = 0.46).
In HIV-1 infection, TST and QFT-G-IT immune responses are both strongly related to the degree of immunodeficiency, while results of the T-Spot.TB are independent of the level of CD4+ T-cell depletion.
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