Trial reportClinical infectious diseases : an official publication of the Infectious Diseases Society of America2021
Effects of Pregnancy and Isoniazid Preventive Therapy on Mycobacterium tuberculosis Interferon Gamma Response Assays in Women With HIV.
Trial report in Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers.
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Who cites it
17 citing papers in PubMed.
- Timing of maternal isoniazid preventive therapy on tuberculosis infection among infants exposed to HIV in low-income and middle-income settings: a secondary analysis of the TB APPRISE trial.The Lancet. Child & adolescent health · 2023Trial
- Immunogenicity of Conjugated and Polysaccharide Pneumococcal Vaccines Administered During Pregnancy or Postpartum to Women With HIV.The Journal of infectious diseases · 2022Trial
- Tuberculosis in Pregnancy: Challenges of Immune Protection.The Journal of infectious diseases · 2026Review
- IMPAACT 2041: Designing the Study of Glecaprevir/Pibrentasvir Treatment During Pregnancy.Open forum infectious diseases · 2026Article
- Review
- Tuberculosis preventive therapy in postpartum women with HIV modifiesFrontiers in immunology · 2026Article
- DiminishedOpen forum infectious diseases · 2025Article
- Physiological stage-dependent effects ofFrontiers in microbiology · 2025Article
- The impact of IGRA positivity in untreated inactive pulmonary tuberculosis on IVF-ET outcomes in infertile women: an ambispective cohort study.Frontiers in medicine · 2025Article
- Impact ofFrontiers in immunology · 2024Article
- Impact of Human Immunodeficiency Virus and Peripartum Period on Mycobacterium tuberculosis Infection Detection.The Journal of infectious diseases · 2023Article
- HIV/Tuberculosis Coinfection in Pregnancy and the Postpartum Period.Journal of clinical medicine · 2023Review
- Diagnostic biomarkers for active tuberculosis: progress and challenges.EMBO molecular medicine · 2022Review
- Tuberculosis Infection in Pregnant People: Current Practices and Research Priorities.Pathogens (Basel, Switzerland) · 2022Review
- Dynamics of Mycobacterium tuberculosis-Specific and Nonspecific Immune Responses in Women with Tuberculosis Infection during Pregnancy.Microbiology spectrum · 2022Article
- Interferon Gamma Release Assay and Tuberculin Skin Test Performance in Pregnant Women Living With and Without HIV.Journal of acquired immune deficiency syndromes (1999) · 2022Article
- Longitudinal Mycobacterium tuberculosis-Specific Interferon Gamma Responses in Ethiopian HIV-Negative Women during Pregnancy and Postpartum.Journal of clinical microbiology · 2021Article
Corrections and comments
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Authors and funding
24 authors.
Funding
Abstract
backgroundPregnancy is accompanied by immune suppression. We hypothesized that Mycobacterium tuberculosis-specific inflammatory responses used to identify latent tuberculosis infection (LTBI) lose positivity during pregnancy. We also hypothesized that isoniazid preventive therapy (IPT) may revert LTBI diagnoses because of its sterilizing activity.
methods944 women with human immunodeficiency virus infection (HIV) participating in a randomized, double-blind, placebo-controlled study comparing 28 weeks of IPT antepartum versus postpartum, were tested by QuantiFERON-gold-in-tube (QGIT) antepartum and by QGIT and tuberculin skin test (TST) at delivery and postpartum. Serial QGIT positivity was assessed by logistic regression using generalized estimating equations.
resultsFrom entry to delivery, 68 (24%) of 284 QGIT-positive women reverted to QGIT-negative or indeterminate. Of these, 42 (62%) recovered QGIT positivity postpartum. The loss of QGIT positivity during pregnancy was explained by decreased interferon gamma (IFNγ) production in response to TB antigen and/or mitogen. At delivery, LTBI was identified by QGIT in 205 women and by TST in 113 women. Corresponding numbers postpartum were 229 and 122 women. QGIT and TST kappa agreement coefficients were 0.4 and 0.5, respectively. Among QGIT-positive women antepartum or at delivery, 34 (12%) reverted to QGIT-negative after IPT. There were no differences between women who initiated IPT antepartum or postpartum.
conclusionsDecreased IFNγ responses in pregnancy reduced QGIT positivity, suggesting that this test cannot reliably rule out LTBI during pregnancy. TST was less affected by pregnancy, but had lower positivity compared to QGIT at all time points. IPT was associated with loss of QGIT positivity, the potential clinical consequences of which need to be investigated.
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