https://scholars.lib.ntu.edu.tw/handle/123456789/479891
Title: | Strategy to Better Select HIV-Infected Individuals for Latent TB Treatment in BCG-Vaccinated Population | Authors: | Yang C.-H. Chan P.-C. Liao S.-T. Cheng S.-H. Wong W.-W. LI-MIN HUANG PO-REN HSUEH Chiou H.-Y. |
Issue Date: | 2013 | Journal Volume: | 8 | Journal Issue: | 8 | Start page/Pages: | e73069 | Source: | PLoS ONE | Abstract: | Objective:To evaluate the T-SPOT.TB interferon-γ releasing assay and the tuberculin skin test (TST), for the diagnosis of latent tuberculosis infection(LTBI) and the development of subsequent active tuberculosis, in BCG-vaccinated HIV-infected individuals.Methods:HIV-infected individuals without clinical suspicion of active TB or a past history of TB were enrolled from 1 January 2008 to 30 November 2010. Both T-SPOT.TB test and TST were offered to the participants whom were followed up prospectively until April 30, 2012 for development of TB.Results:Among the 909 participants, 25% had positive TST reactions with cut-off point of 5 mm and 15% had positive T-SPOT.TB results. After a median follow-up of 2.97 years, there were 5 cases developed culture-confirmed active TB (all had dual positive TST and T-SPOT.TB results), and the incidence was 0.17 per 100 person-years. The relative risks (RRs) for subsequent active TB in HIV-infected individuals with positive TST results, positive T-SPOT.TB results and dual positive results compared with the risk for individuals with negative results were 40.6 (95% CI 2.1-767.9), 73.9 (95% CI 3.9-1397.7) and 226.5 (95% CI 12.0-4284), respectively. The number needed to treat to prevent one subsequent TB case among patients with a positive TST, a positive T-SPOT.TB and dual positive results was 35, 22 and 8 respectively.Conclusions:Adopting positive results of the TST and T-SPOT.TB to screen LTBI among BCG-vaccinated HIV-infected individuals might be feasible. Number needed to treat for isoniazid preventive therapy could be reduced significantly by using dual positive strategy. ? 2013 Yang et al. |
URI: | https://scholars.lib.ntu.edu.tw/handle/123456789/479891 | ISSN: | 1932-6203 | DOI: | 10.1371/journal.pone.0073069 | SDG/Keyword: | antiretrovirus agent; BCG vaccine; adult; article; bacterium culture; BCG vaccination; controlled clinical trial; controlled study; diagnostic test accuracy study; diagnostic value; female; human; Human immunodeficiency virus infected patient; Human immunodeficiency virus infection; interferon gamma release assay; intermethod comparison; latent tuberculosis; major clinical study; male; medical history; patient selection; population research; reference value; risk assessment; risk factor; tuberculin test; Adult; Aged; Aged, 80 and over; Antitubercular Agents; Female; Follow-Up Studies; HIV Infections; Humans; Isoniazid; Latent Tuberculosis; Male; Middle Aged; Mycobacterium bovis; Tuberculin Test |
Appears in Collections: | 醫學院附設醫院 (臺大醫院) |
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