Impact of HIV and peripartum period on Mycobacterium tuberculosis infection detection.
HIV
interferon gamma-release assay (IGRA)
pregnancy
tuberculin skin test (TST)
tuberculosis infection
Journal
The Journal of infectious diseases
ISSN: 1537-6613
Titre abrégé: J Infect Dis
Pays: United States
ID NLM: 0413675
Informations de publication
Date de publication:
28 Sep 2023
28 Sep 2023
Historique:
received:
10
03
2023
revised:
09
06
2023
accepted:
26
09
2023
medline:
28
9
2023
pubmed:
28
9
2023
entrez:
28
9
2023
Statut:
aheadofprint
Résumé
Pregnancy and HIV may influence TB infection (TBI) detection using interferon gamma-release assays (QFT-Plus) and tuberculin skin tests (TST). Participants from antenatal clinics in Western Kenya underwent QFT-Plus and TST in pregnancy, 6-weeks (6wkPP) and 12-months postpartum (12moPP). 400 participants (200 WHIV/200 HIV-negative) enrolled in pregnancy at median 28 weeks gestation (IQR 24-30).QFT-Plus + prevalence was higher than TST + in pregnancy (32.5% vs. 11.6%) and through 12moPP (6wkPP: QFT-Plus 30.9% vs. TST 18.0%, 12moPP: QFT-Plus 29.5% vs. TST 17.1%, all p < 0.001), driven primarily QFT-Plus+/TST- discordance among HIV-negative women.TBI test conversion incidence was 28.4/100PY, and higher in WHIV vs. HIV-negative women (35.5 vs. 20.9/100PY, HR 1.73 [95%CI 1.04-2.88]), mostly due to early postpartum TST conversion among WHIV.Among QFT-Plus + participants in pregnancy, Mtb-specific IFN-γ responses were dynamic from pregnancy to 12moPP and were lower among WHIV vs. HIV-negative women with TBI at all time points. QFT-Plus had higher TBI diagnostic yield than TST in peripartum women with/without HIV. Peripartum QFT-Plus + prevalence was stable and less influenced by HIV than TST. Mtb-specific IFN-γ responses were dynamic and lower among WHIV. TBI test conversion incidence was high between pregnancy and early postpartum, potentially due to postpartum immune recovery.
Sections du résumé
BACKGROUND
BACKGROUND
Pregnancy and HIV may influence TB infection (TBI) detection using interferon gamma-release assays (QFT-Plus) and tuberculin skin tests (TST).
METHODS
METHODS
Participants from antenatal clinics in Western Kenya underwent QFT-Plus and TST in pregnancy, 6-weeks (6wkPP) and 12-months postpartum (12moPP).
RESULTS
RESULTS
400 participants (200 WHIV/200 HIV-negative) enrolled in pregnancy at median 28 weeks gestation (IQR 24-30).QFT-Plus + prevalence was higher than TST + in pregnancy (32.5% vs. 11.6%) and through 12moPP (6wkPP: QFT-Plus 30.9% vs. TST 18.0%, 12moPP: QFT-Plus 29.5% vs. TST 17.1%, all p < 0.001), driven primarily QFT-Plus+/TST- discordance among HIV-negative women.TBI test conversion incidence was 28.4/100PY, and higher in WHIV vs. HIV-negative women (35.5 vs. 20.9/100PY, HR 1.73 [95%CI 1.04-2.88]), mostly due to early postpartum TST conversion among WHIV.Among QFT-Plus + participants in pregnancy, Mtb-specific IFN-γ responses were dynamic from pregnancy to 12moPP and were lower among WHIV vs. HIV-negative women with TBI at all time points.
CONCLUSIONS
CONCLUSIONS
QFT-Plus had higher TBI diagnostic yield than TST in peripartum women with/without HIV. Peripartum QFT-Plus + prevalence was stable and less influenced by HIV than TST. Mtb-specific IFN-γ responses were dynamic and lower among WHIV. TBI test conversion incidence was high between pregnancy and early postpartum, potentially due to postpartum immune recovery.
Identifiants
pubmed: 37768184
pii: 7285268
doi: 10.1093/infdis/jiad416
pii:
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Informations de copyright
© The Author(s) 2023. Published by Oxford University Press on behalf of Infectious Diseases Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.