第三代和第四代QuantiFERON-TB金测定在印度妊娠阶段的不一致。

IF 1.9 Q3 INFECTIOUS DISEASES

Journal of Clinical Tuberculosis and Other Mycobacterial Diseases Pub Date : 2025-02-01 DOI:10.1016/j.jctube.2024.100504

Vandana Kulkarni , Mallika Alexander , Ramesh Bhosale , Divyashri Jain , Prasad Deshpande , Emily Shira Gitlin , Arthi Vaidyanathan , Andrea Chalem , Shilpa Naik , Nikhil Gupte , Neelu Nawani , Amita Gupta , Jyoti Mathad

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引用次数: 0

摘要

背景：妊娠和HIV影响CD4+ T淋巴细胞，影响QuantiFERON-TB Gold （QFT）的性能。我们将QFT的结果与QuantiFERON-TB Gold Plus （QFT-Plus）的结果进行了比较，QFT-Plus也测量了CD8+在怀孕和产后对TB抗原的反应。方法：采用IGRA对516例孕妇进行TB感染筛查。在165名IGRA阳性孕妇中，比较了QFT和QFT- plus在分娩和产后的结果。对74名在怀孕、分娩和产后接受QFT-Plus检测的孕妇进行QFT-Plus的纵向变化评估。结果：通过IGRA +队列的横断面分析，分娩时QFT- plus的阳性率高于QFT (80% vs 65%, p = 0.04)，但产后无差异。在35名感染艾滋病毒的妇女中，QFT- plus在分娩和产后的阳性结果比QFT更多(76%比47%，p = 0.08；90% vs 80%, p = 0.54)，但没有统计学意义。纵向上，TB1或TB2的QFT-Plus阳性在产前、分娩和产后最高(74%、58%、62%；p = 0.09)，并且在未感染艾滋病毒的妇女中优于单独使用TB1 (100% vs 90%, p = 0.04)，而在感染艾滋病毒的妇女中则不然。结论：QFT- plus的表现在整个怀孕期间是一致的，包括在分娩时，QFT阳性较低。QFT-Plus可能提高孕妇产前TBI的检测。

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Discordance of 3rd and 4th generation QuantiFERON-TB Gold assays by pregnancy stages in India

Background

Pregnancy and HIV affect CD4+ T lymphocytes and impact performance of QuantiFERON-TB Gold (QFT). We compared the results of QFT with QuantiFERON-TB Gold Plus (QFT-Plus), which also measures CD8+ responses to TB antigens, during pregnancy and postpartum.

Methods

We screened 516 pregnant women for TB infection (TBI) with IGRA. From 165 IGRA + pregnant women, QFT vs QFT-Plus results were compared at delivery and postpartum. Longitudinal changes in QFT-Plus were assessed in 74 pregnant women who received QFT-Plus testing at pregnancy, delivery, and postpartum.

Results

Through cross-sectional analysis of the IGRA + cohort, QFT-Plus showed higher positivity than QFT (80 % vs 65 %, p = 0.04) at delivery but no difference postpartum. Among 35 women with HIV, QFT-Plus returned more positive results than QFT at delivery and postpartum (76 % vs 47 %, p = 0.08; 90 % vs 80 %, p = 0.54), though not statistically significant. Longitudinally, QFT-Plus positivity by TB1 or TB2 was highest antepartum vs. delivery and postpartum (74 % vs. 58 % vs. 62 %; p = 0.09) and performed better than TB1 alone (100 % vs 90 %, p = 0.04) in women without HIV but not in women with HIV.

Conclusions

Performance of QFT-Plus was consistent across pregnancy, including at delivery when QFT positivity is lower. QFT-Plus may enhance antenatal TBI detection among pregnant women.

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来源期刊

Journal of Clinical Tuberculosis and Other Mycobacterial Diseases Medicine-Pulmonary and Respiratory Medicine

CiteScore

4.00

自引率

5.00%

发文量

审稿时长

30 weeks

期刊介绍： Journal of Clinical Tuberculosis and Mycobacterial Diseases aims to provide a forum for clinically relevant articles on all aspects of tuberculosis and other mycobacterial infections, including (but not limited to) epidemiology, clinical investigation, transmission, diagnosis, treatment, drug-resistance and public policy, and encourages the submission of clinical studies, thematic reviews and case reports. Journal of Clinical Tuberculosis and Mycobacterial Diseases is an Open Access publication.