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P2.045 Serial Testing with an Interferon-Gamma Release Assay in HIV-1-Infected Individuals
  1. M C Aichelburg1,
  2. T Reiberger2,
  3. F Breitenecker1,
  4. A Makristathis3,
  5. A Rieger1
  1. 1Department of Dermatology, Division of Immunology, Allergy and Infectious Diseases (DIAID), Medical University of Vienna, Vienna, Austria
  2. 2Department of Internal Medicine III, Division of Gastroenterology & Hepatology, Vienna HIV & Liver Study Group, Medical University of Vienna, Vienna, Austria
  3. 3Department of Hygiene and Medical Microbiology, Division of Clinical Microbiology, Medical University of Vienna, Vienna, Austria

Abstract

Background The clinical utility of serial screening for tuberculosis (TB) by interferon-gamma release assays has not been established in HIV-1-infected individuals.

Methods In this prospective study HIV-1-infected subjects underwent repeated QuantiFERON-TB Gold In-Tube assay (QFT-GIT) testing at baseline and after 24 months to determine the rate of conversions and reversions in a low TB-incidence country. Data on demographics, history of tuberculosis and HIV-1 parameters were obtained and risk factors associated with conversion or reversion of QFT-GIT results were assessed in a multivariate regression model.

Results Of 846 HIV-1-infected subjects, 9% (76/846) were QFT-GIT positive, 85% (718/846) were QFT-GIT negative and 6% (52/846) QFT-GIT indeterminate at baseline, respectively. Concordant baseline and follow-up results were observed in 86% (686/794) of subjects. The observed inter-test agreement was 0.887 (95% CI: 0.847–0.899) while the inter-test agreement of serial QFT-GIT testing was moderate (Cohan κ-coefficient = 0.448). QFT-GIT conversions occurred in 9% (63/718) of individuals while QFT-GIT reversions were seen in 33% (25/76). Independent predictors for QFT-GIT conversion were origin from high TB incidence country (OR, 1.93; P = 0.024) and intravenous drug abuse (OR, 2.43; P = 0.016). Of the 10 active TB cases during follow-up 5 had concordant positive QFT-GIT results and 2 were QFT-GIT converters.

Conclusions TB screening in HIV-1 patients by serial QFT-GIT assays may be of clinical value due to its excellent reproducibility. However, QFT-GIT conversions and reversions should be interpreted carefully as their clinical significance remains to be established.

  • conversion
  • interferon-γ release assay
  • reversion

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