ArticlePloS one2009
The impact of HIV infection and CD4 cell count on the performance of an interferon gamma release assay in patients with pulmonary tuberculosis.
Article in PloS one, 2009. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 38 papers, 5 of them syntheses that pooled it.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
38 citing papers in PubMed, 5 syntheses or guidelines pooled it, 110 citations in OpenAlex.
- Pooled it
- Risk Factors for Indeterminate Interferon-Gamma Release Assay for the Diagnosis of Tuberculosis in Children-A Systematic Review and Meta-Analysis.Frontiers in pediatrics · 2019Pooled it
- Interferon-γ release assays for active pulmonary tuberculosis diagnosis in adults in low- and middle-income countries: systematic review and meta-analysis.The Journal of infectious diseases · 2011Pooled it
- Interferon-gamma release assays for the diagnosis of latent tuberculosis infection in HIV-infected individuals: a systematic review and meta-analysis.Journal of acquired immune deficiency syndromes (1999) · 2011Pooled it
- Pooled it
- The impact of an oral glucose load on IFN-γ-release in persons infected with Mycobacterium tuberculosis.BMC infectious diseases · 2024Trial
- Trial
- The Impact of Body Mass Index on Latent Tuberculosis Infection: Combined Assessment in People Living with HIV.Pathogens (Basel, Switzerland) · 2025Article
- Risk Factors Associated With Tuberculosis Infection Among Household Contacts of Patients With Microbiologically Confirmed Pulmonary Tuberculosis in 3 High Tuberculosis Burden Countries.The Journal of infectious diseases · 2025Article
- Article
- Serum cytokine biosignatures for identification of tuberculosis among HIV-positive inpatients.Thorax · 2024Article
- The Yield of Active Tuberculosis Disease and Latent Tuberculosis Infection in Tuberculosis Household Contacts Investigated Using Chest X-ray in Yogyakarta Province, Indonesia.Tropical medicine and infectious disease · 2024Article
- Analyses of blood-derived host biomarkers for pulmonary tuberculosis diagnosis in human immunodeficiency virus co-infected individuals in sub-Saharan Africa: a systematic review and meta-analysis.Frontiers in tuberculosis · 2024Article
- Understanding the Decline of Incident, Active Tuberculosis in People With Human Immunodeficiency Virus in Switzerland.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2023Article
- Prevalence and predictors of tuberculosis infection among people living with HIV in a high tuberculosis burden context.BMJ open respiratory research · 2023Article
- Factors Influencing False-Negative Results of QuantiFERON-TB Gold In-Tube (QFT-GIT) in Active Tuberculosis and the Desirability of Resetting Cutoffs for Different Populations: A Retrospective Study.Tropical medicine and infectious disease · 2022Article
- Diagnostic Value of Interferon-Gamma Release Assays for Tuberculosis in the Immunocompromised Population.Diagnostics (Basel, Switzerland) · 2022Review
- Joint Modeling in Detecting Predictors of CD4 Cell Count and Status of Tuberculosis Among People Living with HIV/AIDS Under HAART at Felege Hiwot Teaching and Specialized Hospital, North-West Ethiopia.HIV/AIDS (Auckland, N.Z.) · 2021Article
- Tuberculosis Skin Test Screening in the National Tuberculosis Program of Trinidad and Tobago.Healthcare (Basel, Switzerland) · 2020Article
- Article
Corrections and comments
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Authors and funding
11 authors at 5 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe performance of the tuberculosis specific Interferon Gamma Release Assays (IGRAs) has not been sufficiently documented in tuberculosis- and HIV-endemic settings. This study evaluated the sensitivity of the QuantiFERON TB-Gold In-Tube (QFT-IT) in patients with culture confirmed pulmonary tuberculosis (PTB) in a TB- and HIV-endemic population and the effect of HIV-infection and CD4 cell count on test performance. METHODOLOGY/PRINCIPAL
findings161 patients with sputum culture confirmed PTB were subjected to HIV- and QFT-IT testing and measurement of CD4 cell count. The QFT-IT was positive in 74% (119/161; 95% CI: 67-81%). Sensitivity was higher in HIV-negative (75/93) than in HIV-positive (44/68) patients (81% vs. 65%, p = 0.02) and increased with CD4 cell count in HIV-positive patients (test for trend p = 0.03). 23 patients (14%) had an indeterminate result and this proportion decreased with increasing CD4 cell count in HIV-positive patients (test for trend p = 0.03). Low CD4 cell count (<300 cells/microl) did not account for all QFT-IT indeterminate nor all negative results. Sensitivity when excluding indeterminate results was 86% (95% CI: 81-92%) and did not differ between HIV-negative and HIV-positive patients (88 vs. 83%, p = 0.39). CONCLUSIONS/SIGNIFICANCE: Sensitivity of the QFT-IT for diagnosing active PTB infection was reasonable when excluding indeterminate results and in HIV-negative patients. However, since the test missed more than 10% of patients, its potential as a rule-out test for active TB disease is limited. Furthermore, test performance is impaired by low CD4 cell count in HIV-positive patients and possibly by other factors as well in both HIV-positive and HIV-negative patients. This might limit the potential of the test in populations where HIV-infection is prevalent.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.