Poor concordance between interferon-γ release assays and tuberculin skin tests in diagnosis of latent tuberculosis infection among HIV-infected individuals
2009

Poor agreement between tests for latent tuberculosis in HIV patients

Sample size: 336 publication Evidence: low

Author Information

Author(s): Naasha J Talati, Ulrich Seybold, Bianca Humphrey, Abiola Aina, Jane Tapia, Paul Weinfurter, Rachel Albalak, Henry M Blumberg

Primary Institution: Emory University, School of Medicine

Hypothesis

How do interferon-γ release assays compare to tuberculin skin tests in diagnosing latent tuberculosis infection among HIV-infected individuals?

Conclusion

The study found a low prevalence of latent tuberculosis infection and poor concordance between the three diagnostic tests used.

Supporting Evidence

  • Only 27 out of 336 patients tested positive for latent tuberculosis infection.
  • The agreement between the three diagnostic tests was poor, with kappa values indicating low concordance.
  • Indeterminate test results were more common in patients with CD4 counts ≤ 200 cells/μl.

Takeaway

Doctors used three different tests to check for tuberculosis in people with HIV, but they didn't agree much on the results.

Methodology

A cross-sectional study was conducted at two HIV clinics in Atlanta comparing two IGRA tests and the tuberculin skin test.

Limitations

The low prevalence of positive test results limited the ability to evaluate risk factors associated with positive results.

Participant Demographics

{"median_age":42,"sex_distribution":{"male":65,"female":35},"race_distribution":{"African American":85.1,"Caucasian":11.6,"Hispanic":2.1,"Asian":1.2},"CD4_count":{"median":335,"percentage_below_200":30.1},"viral_load":{"median":400}}

Statistical Information

Confidence Interval

{"TST_TSPOT":"95% CI (-0.06, 0.39)","TST_QFT":"95% CI (-0.05, 0.51)","QFT_TSPOT":"95% CI (-0.1, 0.2)"}

Digital Object Identifier (DOI)

10.1186/1471-2334-9-15

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