Comparision For Different Methods To Detect Latent Tuberculosis Infection In HIV/AIDS Patients

Objective:In order to find the sensitive, cheap and easy to operate method of latent tuberculosis infection screening tests, this research adopts the common tuberculosis diagnostic kits on the market for latent tuberculosis in patients with HIV/AIDS screening, comparative analysis of the sensitivity of diagnosis, to provide data support for clinical diagnosis and treatment of mycobacterium tuberculosis latent infectionsReserch method:The study object are hospital outpatient and inpatient patients of HIV/AIDS from Yunnan Provincial Hospital of Infectious Disease, and the control are medical workers and medical people. Combining the four methods: The tuberculin skin test(TST),IGRA test(Beijing wantai TB-IGRA, wuhan sea climbed IGRA-TB), the t-spot.tb test(T-SPOT. TB), to diagnose latent tuberculosis for all objects.Result:(1)Using TST, T-SPOT. TB, Beijing wantai TB-IGRA and wuhan sea climbed IGRA-TB four detection methods in 121 cases of latent tuberculosis infection in patients with HIV/AIDS testing, positive rate was 14.9%, 15.7%, 17.4% and 14.9%respectively. With CD4+T cell count of 200/μL for the sub-group boundaries, positive rates were 20.0%, 14.3%, 14.3% and 11.4% in group of CD4 cell counts lower than200 /μL; 13.6%, 17.3%, 19.6% and 17.3% in group of CD4 cell counts greater than200/μL respectively. There was no statistically significant difference in both group(P>0.05).(2)In 63 cases of medical workers detected latent TB infections, test positive rates of TST, T-SPOT. TB, Beijing wantai TB-IGRA and sea climbed IGRA were 47.6%,30.2%, 39.1%, 27.0%, respectively. TST and T-SPOT. TB, TST and wuhan sea climbed IGRA-TB group of positive detection rate was statistically significant(3)In 50 cases of check-up crowd detect latent TB infections, TST, T-SPOT. TB,wantai TB-IGRA and sea climbed IGRA-four methods of TB test positive rate were26.0%, 24.0%, 22.2% and 24.0%, respectively.(4)With the TST test as the standard to test all subjects, the sensitivity in using the three methods of T-SPOT.TB, TB-IGRA of Wan Tai and IGRA-TB of Hegyi were62.5% 、 66.0% 、 62.5%;specificity were 90.4%, 90.4%, 91.0%. For HIV / AIDS patients, the sensitivity of the three methods were 55.0%, 65.0%, 65.0%,and specificity were: 92.1%, 92.1%, 91.1%; For medical workers, the sensitivity of the three methods were 58.6%, 65.2%, 51.7%, and specificity were 94.1%, 87.0%, 94.1%;For healthy people, the sensitivity of the three methods were 53.8%, 66.7%,76.9%,and specificity were 91.9%, 92.6%, 94.6%.Conclusion:(1)The positivity rates of the four methods : PPD,T-SPOT.TB, TB-IGRA of Wan Tai in Beijing and IGRA-TB of Hegyi in Wuhan were basically the same to test LTBI.(2)Comparision for positivity rates of the four methods in group of CD4 cell counts lower than 200/μL and in group of CD4 cell counts greater than 200/μL respectively.There was no statistically significant difference in both group(P>0.05).(3) This study found that patients with HIV/AIDS positive rate of latent tuberculosis was relatively lower than medical workers and physical examination population.(4)The studied found that the sensitivity and specificity were not strong in HIV/AIDS patients with γ-interferon release assay to dignose the different populations.