Efficacy and Risk Factors of Interferon-Gamma Release Assays among HIV-Positive Individuals

Huifang Qin; Yiting Wang; Liwen Huang; Yan Huang; Jing Ye; Guijin Liang; Chongxing Zhou; Dabin Liang; Xiaoyan Liang; Yanlin Zhao; Mei Lin

doi:10.3390/ijerph20054556

Efficacy and Risk Factors of Interferon-Gamma Release Assays among HIV-Positive Individuals

Int J Environ Res Public Health. 2023 Mar 4;20(5):4556. doi: 10.3390/ijerph20054556.

Authors

Huifang Qin^{1

2}, Yiting Wang^{3

4}, Liwen Huang², Yan Huang^{1

2}, Jing Ye^{1

2}, Guijin Liang², Chongxing Zhou^{1

2}, Dabin Liang^{1

2}, Xiaoyan Liang², Yanlin Zhao⁴, Mei Lin^{1

2}

Affiliations

¹ Guangxi Key Laboratory of Major Infectious Disease Prevention and Control and Biosafety Emergency Response, Nanning 530028, China.
² Guangxi Zhuang Autonomous Region Center for Disease Control and Prevention, Nanning 530028, China.
³ Institute for Immunization and Prevention, Beijing Center for Disease Prevention and Control, Beijing 100013, China.
⁴ National Tuberculosis Reference Laboratory, Chinese Center for Disease Control and Prevention, Beijing 102206, China.

Abstract

Latent tuberculosis is prevalent in HIV-infected people and has an impact on the progression of AIDS. The aim of this study is to match a more accurate IGRA method for the better detection of latent tuberculosis infection in HIV patients. All 2394 patients enrolled were tested using three IGRA methods. The positive rate consistency of pairwise comparison and risk factors were analyzed. Receiver operator characteristic (ROC) curve analysis was applied to evaluate the diagnostic value of T-SPOTTB. The positive rates of the three methods were statistically different (p < 0.001). The CD4⁺ T cell number statistically impacted the QuantiFERON and Wan Tai tests after the analysis with univariate logistic regression, while no statistical difference was observed in T-SPOT.TB. Additionally, there was a better sensitivity and specificity of T-SPOT.TB if the positive cut-off value of ESAT-6 and CFP-10 was 4.5 and 5.5, respectively. This study provides an insight into the IGRA methods and demonstrated that the positive response detected via QuantiFERON declined with decreased CD4⁺ T cells in the HIV-infected population; T-SPOT.TB functions independently of the CD4⁺ T cell level and Wan Tai was affected in some cases. This will be useful in the diagnosis of LTBI in the HIV-infected population, which will be a key step toward TB elimination in China.

Keywords: HIV; IGRA; latent TB infection.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

HIV Infections* / epidemiology
Humans
Interferon-gamma Release Tests / methods
Latent Tuberculosis* / epidemiology
Risk Factors
Tuberculin Test / methods

Substances

IFNG protein, human

Grants and funding

The work described here was funded by Guangxi key research and development project (AB18221010), the Key Science and Technology project of China’s 13th Five-Year Plan (2018ZX10103001), Guangxi Medical and health key discipline construction project and Self-funded project by Guangxi Health Committee (NO.Z-A20220357).