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Int J Infect Dis. 2015 Jul;36:46-53. doi: 10.1016/j.ijid.2015.05.006. Epub 2015 May 21.

Impact of tuberculosis treatment and antiretroviral therapy on serial RD-1-specific quantitative T-cell readouts (QuantiFERON-TB Gold In-Tube), and relationship to treatment-related outcomes and bacterial burden.

Author information

1
South African Medical Research Council, Parow Valley, Cape Town, South Africa.
2
KwaZulu-Natal Research Institute for Tuberculosis and HIV (K-RITH), Nelson Mandela School of Medicine, Durban, South Africa.
3
South African Medical Research Council, Biostatistics Department, Durban, South Africa.
4
World Health Organization/Special Programme for Research and Training in Tropical diseases (TDR), Geneva, Switzerland.
5
Lung Infection and Immunity Unit, Division of Pulmonology, Department of Medicine, University of Cape Town, J flr, Old Main Bldg, Groote Schuur Hospital, Observatory, Cape Town, 7925, South Africa.
6
Lung Infection and Immunity Unit, Division of Pulmonology, Department of Medicine, University of Cape Town, J flr, Old Main Bldg, Groote Schuur Hospital, Observatory, Cape Town, 7925, South Africa. Electronic address: keertan.dheda@uct.ac.za.

Abstract

BACKGROUND:

The impact of anti-tuberculosis treatment with and without antiretroviral therapy (ART) on standardized interferon gamma release assay (IGRA) readouts has been studied inadequately in high-burden countries.

METHODS:

The QuantiFERON-TB Gold In-Tube (QFT-GIT) test was used to evaluate interferon gamma (IFN-γ) responses longitudinally (0, 3, 6, and 12 months post initiation of tuberculosis (TB)-HIV co-treatment or ART alone) in 82 HIV-infected patients.

RESULTS:

Of the 65 evaluable participants, 30 were co-infected on ART, 17 were co-infected but not on ART, and 18 were HIV-infected alone and on ART. In HIV-infected and HIV-TB-infected patients on ART, IFN-γ responses increased, whilst they decreased in those not on ART. However, baseline, month 3, and month 6 IFN-γ responses, irrespective of ART, did not differ in TB-HIV co-infected patients who culture-converted compared to those who did not (1.25 vs. 1.05, p=0.5 at baseline; 3.76 vs. 1.15, p=0.2 for month 3; 0.06 vs. 0.7, p=0.3 for month 6). IFN-γ levels did not correlate with the magnitude of sputum bacillary load, smear status, or liquid culture time-to-positivity.

CONCLUSION:

As IGRAs do not correlate with 2- or 6-month culture conversion or with markers of bacillary burden, they are unlikely to be useful for the prognostication of treatment outcome in co-infected patients.

KEYWORDS:

Antiretrovirals; HIV; Interferon gamma release assay; QuantiFERON-TB Gold In-Tube; Tuberculosis

PMID:
26003404
DOI:
10.1016/j.ijid.2015.05.006
[Indexed for MEDLINE]
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