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longitudinal observation of an interferon gamma-released assay （***） for Mycobacterium tuberculosis infection in AIDS patients on highly active antiretroviral therapy

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Chinese Medical Journal 2010年第9期123卷 1117-1121页

作者： ZHANG Li-fan LIU Xiao-qing ZUO Ling-yan LI Tai-sheng DENG Guo-hua WANG Ai-xia Department of Infectious Diseases Peking Union Medical College HospitalChinese Academy of Medical Sciences & Peking Union Medical CollegeBeijing 100730China

Background *** is a novel test for tuberculosis infection with higher sensitivity and specificity than the traditional tuberculin skin test （TST）. However, there are no longitudinal data in the literature evaluating *** for Mycobacterium tuberculosis in patients with acquired immune deficiency syndrome （AIDS） on highly active antiretroviral therapy （HAART）. The objective of this study was to assess the value of *** longitudinally in AIDS patients on HAART without prophylaxis for *** A prospective observational study was conducted in 50 AIDS patients on HAART. None of the subjects had evidence of active tuberculosis. ***, a T-cell-based interferon y released assay, was performed at the onset of the study and repeated 24 months thereafter. Subjects were evaluated every 6 months during the 36-month follow-up. Results Twenty-one （42%） AIDS patients on HAART tested positive by *** （95% Cl 28.3%-55.7%）. The pooled spot-forming cells of early secretory antigenic target-6 （ESAT-6） and culture filtrate protein-10 （CFP-10） peptides were 68/million peripheral blood mononuclear cell （PBMC）（interquartile range 44-220）. The average number of CD4 cells in subjects was （305±152） cells/Ml and there was no significant difference in *** response rates between subjects with CD4 cell counts 〈200 cells/ul （7/15 （46.7%）, 95% C/21.5%-71.9%） and those with CD4 cell counts≥200 cells/ul （14/35 （40.0%）, 95% Cl 23.8%-56.2%, P=0.662）. In the 32 subjects who completed the 24-month follow-up, 10 underwent *** reversion, one had *** conversion, six remained positive and 15 remained negative. None of them advanced to active tuberculosis during the 36-month *** The inactive status of tuberculosis infection may be maintained for a long period in AIDS patients on HAART.

关键词： T-SPOT.TB Mycobacterium tuberculosis AIDS highly active antiretmviral therapy longitudinal assessment

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