Sensitivity of IFN-γ Release Assay to Detect Latent Tuberculosis Infection Is Retained in HIV-Infected Patients but Dependent on HIV/AIDS Progression

BACKGROUND: Detection and treatment of latent TB infection (LTBI) in HIV infected individuals is strongly recommended to decrease morbidity and mortality in countries with high levels of HIV. OBJECTIVE: To assess the validity of a newly developed in-house ELISPOT interferon-gamma release assay (IGRA) for the detection of LTBI amongst HIV infected individuals, in comparison with the Tuberculin Skin Test (TST). METHODOLOGY/PRINCIPAL FINDINGS: ESAT6/CFP10 (EC) ELISPOT assays were performed, together with a TST, in 285 HIV infected individuals recruited in HIV clinics in Dakar, Senegal, who had no signs of active TB at time of enrolment. Thirty eight of the subjects (13.3%) failed to respond to PHA stimulation and were excluded from the analysis. In the 247 remaining patients, response to PHA did not vary according to CD4 cell count categories (p = 0.51). EC ELISPOT was positive in 125 (50.6%) subjects, while 53 (21.5%) had a positive TST. Concordance between EC ELISPOT and TST was observed in 151 patients (61.1%) (kappa = 0.23). The proportion of subjects with a positive response to the EC ELISPOT assay decreased with declining CD4 counts (p trend = 0.001), but were consistently higher than the proportion of TST responders. In multivariate analysis, the risk of being EC-ELISPOT positive in HIV infected individuals was associated with age, CD4 count and HIV-1 strain. CONCLUSION: Our study indicates that IGRAs using M. tuberculosis specific antigens are likely to retain their validity for the diagnosis of LTBI among HIV positive individuals, but may be impaired by T-cell anergy in severely immuno-suppressed individuals

Incidence et risque résiduel de transmission des virus de l’hépatite B et C par transfusion sanguine à Bobo-Dioulasso (Burkina Faso) : Étude de cohorte

l’objectif de notre étude était d’évaluer l’incidence et le risque de  transmission des virus des hépatites B et C par transfusion. nous avons conduit une étude de cohorte rétrospective de janvier 2009 à décembre 2014 portant sur les dons de 12 969 donneurs bénévoles et réguliers de sang au Centre Régional de Transfusion Sanguine de Bobo-dioulasso. le diagnostic de l’infection par le VhC ou le VhB était obtenu par technique eliSa devant la présence dans le sérum des anticorps anti-VhC pour le VhC ou de l’antigène hBs pour ce qui est du VhB. le taux d’incidence du VhB était de 2,16 pour 100 donneurs-années et celui du VhC était de 2,59 pour 100 donneurs-années. le risque de transmission du VhB était estimé à 1 pour 302 dons et celui du VhC à 1 pour 213 dons. un renforcement de la sélection des donneurs de sang s’avère indispensable devant un risque élevé de transmission des virus de l’hépatite B et/ou C par don de sang provenant des donneurs bénévoles réguliers.Mots-clés : incidence, Risque résiduel, hépatite B/C, don de sang,  Bobo-dioulasso.The objective of our study was to assess the incidence and risk of   transmission of hepatitis B and C viruses by transfusion. we conducted a retrospective cohort study from January 2009 to december 2014 on the donations of 12,969 volunteer and regular blood donors to the  Bobo-dioulasso Regional Blood Transfusion Center. The diagnosis of infection with hCV or hBV was obtained by eliSa in the presence of serum hCV antibodies for hCV or hBs antigen for hBV. The incidence rate of hBV was 2.16 per 100 years and hCV was 2.59 per 100 years. The risk of transmission of hBV was estimated at 1 for 302 donations and for hCV at 1 for 213 donations. Strengthening the selection of blood donors is essential in view of the high risk of transmission of hepatitis B and / or C viruses through the donation of blood from regular voluntary donors.Keywords: incidence, Residual risk, hepatitis B / C, Blood donation,  Bobo-dioulasso

Analysis of the determinants of positive response to the ESAT6/CFP10 ELISPOT assay and to the TST (n = 247).

<p>Analysis of the determinants of positive response to the ESAT6/CFP10 ELISPOT assay and to the TST (n = 247).</p

Characteristics of patients included in the cohort, with a detail of those responding and those not responding to ELISPOT PHA positive control.

*<p><i>p</i> value for difference between PHA<100 and PHA≥100 SFC/10⁶.</p

Distribution of responses to PHA and ESAT6/CFP10 ELISPOT assays in HIV patients, by CD4 cell count (boxplot showing median, IQR and range) (n = 285).

<p>1A: Distribution of responses to PHA. 1B: Distribution of responses to ESAT6/CFP10.</p