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Predictive value of interferon-gamma release assays for postpartum active tuberculosis in HIV-1-infected women.
Jonnalagadda, S R; Brown, E; Lohman-Payne, B; Wamalwa, D; Farquhar, C; John-Stewart, G C.
Afiliación
  • Jonnalagadda SR; Department of Epidemiology, University of Washington, Seattle, Washington, USA.
Int J Tuberc Lung Dis ; 17(12): 1552-7, 2013 Dec.
Article en En | MEDLINE | ID: mdl-24200267
BACKGROUND: Data on the prognostic utility of interferon-gamma release assays (IGRAs) for active tuberculosis (TB) among human immunodeficiency virus 1 (HIV-1) infected individuals are limited. METHODS: Samples from a perinatal cohort of HIV-1-infected women in Kenya, obtained during pregnancy, were tested using T-SPOT®.TB IGRAs to detect Mycobacterium tuberculosis-specific interferon-gamma (IFN-γ) responses. IFN-γ (cut-off values of >0, ≥6 and ≥10 spot-forming cells [SFC]/well) and CD4 cell count (cut-off values of <250 and <350 cells/l) were evaluated to determine sensitivity and specificity using a time-dependent receiver operating characteristic curve and positive predictive value (PPV) using the Kaplan Meier method for future TB within 1 year postpartum. RESULTS: Of 327 women, 9 developed TB within 1 year postpartum (incidence rate 3.5/100 person-years of follow-up, 95%CI 1.66.7). IFN-γ ≥ 6 SFC/well was associated with an optimal trade-off between sensitivity (78%) and specificity (55%) and a PPV of 5.9%. In women with CD4 cell count of <250 cells/µl, the sensitivity and specificity of IFN- 6 SFC/well were respectively 89% and 63%, and the PPV was 19.2%. CONCLUSION: Among HIV-1 infected women, IFN-γ response (≥6 SFC/well) during pregnancy lacked a high PPV for postpartum TB, but had higher sensitivity and PPV among immunosuppressed women (CD4 cell count of <250 cells/µl).
Asunto(s)

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Tuberculosis / Infecciones por VIH / VIH-1 / Interferón gamma / Coinfección / Ensayos de Liberación de Interferón gamma / Mycobacterium tuberculosis Tipo de estudio: Diagnostic_studies / Incidence_studies / Prognostic_studies / Risk_factors_studies Límite: Female / Humans / Pregnancy País/Región como asunto: Africa Idioma: En Revista: Int J Tuberc Lung Dis Año: 2013 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Francia

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Tuberculosis / Infecciones por VIH / VIH-1 / Interferón gamma / Coinfección / Ensayos de Liberación de Interferón gamma / Mycobacterium tuberculosis Tipo de estudio: Diagnostic_studies / Incidence_studies / Prognostic_studies / Risk_factors_studies Límite: Female / Humans / Pregnancy País/Región como asunto: Africa Idioma: En Revista: Int J Tuberc Lung Dis Año: 2013 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Francia