Objective: To investigate the diagnostic value of T cells spot test of Tuberculosis infection (TSPOT.TB) in human immunodeficiency virus infection/acquired immuodeficiency syndrome patients with positive Mycobacteria culture. Methods: A retrospective study was conducted on 251 HIV infection/AIDS patients with Mycobacteria infection receiving TSPOT.TB test from July 2012 to Dec 2016 in Shanghai Public Health Center affiliated to Fudan University. MPB64 colloidal gold method was taken as the golden standard. The value of TSPOT.TB for diagnosing tuberculosis infection in HIV infection/AIDS patients with positive Mycobacteria culture was analyzed. Patients was divided into groups according the infection site and CD4+ T cell count, and the diagnostic value of TSPOT.TB in patients with extra-pulmonary and pulmonary infection and in patients with CD4+ T≤200/μL and CD4+ T>200/μL was analyzed. Results: Among the 251 HIV infection /AIDS patients with Mycobacteria infection, the diagnostic sensitivity and specificity of TSPOT.TB for Tuberculosis were 83.70% and 80.17%. The diagnostic sensitivity of TSPOT.TB in patients with extra-pulmonary and pulmonary Tuberculosis infection were 85.00% and 82.67%, respectively, and there was no statistical difference( χ2=0.133, P=0.715). The specificity of TSPOT.TB in these two groups were 93.10% and 75.86%, respectively, and there was a statistically significant difference between the two groups ( χ2=4.067, P=0.044). In HIV infection/ AIDS patients with CD4+ T≤200/μL and CD4+ T>200/μL, the diagnostic sensitivity of TSPOT.TB for Tuberculosis was 81.58% and 80.95%, respectively, and there was no statistical difference ( χ2=0.000, P=1.000) between the two groups, yet the specificity of TSPOT.TB were 85.86% and 47.06%, respectively, and the difference was statistically significant ( χ2=11.408, P=0.001). Conclusions: The diagnostic sensitivity of TSPOT.TB for HIV infection/AIDS patients with active Tuberculosis is high, and the infection site and CD4+ T cells counts might not be the impact factors of sensitivity of TSPOT.TB, but they can influence the specificity of TSPOT.TB.
ZHANG Guihong, XIA Qianlin, SHAN Menglin, ZHENG Jianghua
. A preliminary study on diagnostic value of TSPOT.TB in HIV infection/acquired immuodeficiency syndrome patients with positive Mycobacteria culture[J]. Journal of Diagnostics Concepts & Practice, 2017
, 16(04)
: 404
-408
.
DOI: 10.16150/j.1671-2870.2017.04.012
[1] Han YM, Kim HS, Kim CH, et al.Analysis of patients with positive acid-fast bacilli culture and negative T-SPOT.TB results[J]. Korean J Lab Med,2010,30(4):414-419.
[2] Wu X, Li Q, Liang Y, et al.Clinical evaluation of a homemade enzyme-linked immunospot assay for the diag-nosis of active Tuberculosis in China[J]. Mol Biotechnol,2011,47(1):18-25.
[3] Chan CK, Alvarez Bognar F, Wong KH, et al.The epidemiology and clinical manifestations of human immuno-deficiency virus-associated Tuberculosis in Hong Kong[J]. Hong Kong Med J,2010,16(3):192-198.
[4] Narain JP, Lo YR.Epidemiology of HIV-TB in Asia[J]. Indian J Med Res,2004,120(4):277-289.
[5] Haas MK, Daley CL.Mycobacterial lung disease complicating HIV infection[J]. Semin Respir Crit Care Med,2016,37(2):230-242.
[6] Jung JY, Lim JE, Lee HJ, et al.Questionable role of interferon-γ assays for smear-negative pulmonary TB in immunocompromised patients[J]. J Infect,2012,64(2):188-196.
[7] 祁燕伟, 白劲松, 万荣, 等. T细胞斑点试验在人类免疫缺陷病毒合并肺结核感染中不同T细胞水平临床诊断价值[J]. 昆明医学院学报,2011,32(9):63-67.
[8] Kim CH, Kim JY, Hwang YI, et al.Interferon-γ enzyme-linked immunospot assay in patients with Tuberculosis and healthy adults[J]. Tuberc Respir Dis (Seoul),2014, 76(1):23-29.
[9] Kobayashi T, Nishijima T, Teruya K, et al.High mortality of disseminated non-Tuberculous Mycobacterial infection in HIV-infected patients in the antiretroviral therapy era[J]. PLoS One,2016,11(3):e0151682.
[10] Lee YM, Kim SM, Park SJ, et al.Indeterminate T-SPOT.TB test results in patients with suspected extrapulmonary Tuberculosis in routine clinical practice[J]. Infect Chemo-ther,2013,45(1):44-50.
[11] Lee YM, Park KH, Kim SM, et al.Risk factors for false-negative results of T-SPOT.TB and tuberculin skin test in extrapulmonary Tuberculosis[J]. Infection,2013,41(6):1089-1095.
[12] Pan L, Jia H, Liu F, et al.Risk factors for false-negative T-SPOT.TB assay results in patients with pulmonary and extra-pulmonary TB[J]. J Infect,2015,70(4):367-380.
[13] Agarwal S, Nguyen DT, Lew JD, et al.Differential positive TSPOT assay responses to ESAT-6 and CFP-10 in health care workers[J]. Tuberculosis (Edinb),2016,101S:S83-S91.