Quantitative investigation of factors relevant to the T cell spot test for tuberculosis infection in active tuberculosis

Li, Kui; Yang, Caiyong; Jiang, Zicheng; Liu, Shengxi; Li, Jun; Fan, Chuanqi; Li, Tao; Dong, Xuemin

doi:10.1101/561886

Cited by 5 publications

(5 citation statements)

References 36 publications

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“…A previous crosssectional study reported, 300 adult TB patients have surveyed China, they found that most male (90.8%) and female (58.4%) TB patients had insufficient daily protein intake. Li et al found that more TB patients had albumin levels <35 g/L (27). Our results showed that pulmonary TB with respiratory failure patients albumin levels were even lower, ≤30 g/L.…”

Section: Mortality Risk Factors Of Tb Patients With Respiratory Failure During Icu Treatmentsupporting

confidence: 44%

Prediction model for death in patients with pulmonary tuberculosis accompanied by respiratory failure in ICU: retrospective study

et al. 2020

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Background: The mortality rate of pulmonary tuberculosis (TB) patients with respiratory failure remains high. This study aimed to identify factors contributing to death in these patients, and develop a mortality prediction model for pulmonary TB patients with respiratory failure.Methods: A retrospective study of patients admitted consecutively to the medical intensive care unit (ICU) of Beijing Chest Hospital, (Beijing, China), Chaoyang Fourth Hospital (Chaoyang, China) and Hebi Third People's Hospital (Hebi, China) from May 2018 to May 2019 was conducted. 153 patients with pulmonary TB accompanied by respiratory failure were enrolled. A multivariate analysis was performed to identify risk factors for death. A predictive fatality score was determined. The utility of the score for predicting death was evaluated using receiver operating characteristic (ROC) curve analysis. Results: The patients' median age was 57.82±19.42 years (17.0-87.0 years) and there were 106 males (69.28%). The mortality rate was 39.22% (60 of 153). Independent predictive factors of mortality included the PaO 2 (hazard ratio 0.928, 95% CI: 0.882-0.976, P=0.004), Albumin (hazard ratio 0.881, 95% CI: 0.792-0.980, P=0.019), Apache II score (hazard ratio 1.120, 95% CI: 1.017-1.234, P=0.022) and C-reactive protein (hazard ratio 1.012, 95% CI: 1.004-1.019, P=0.003). Establishing a logistic model of the death risk grade of pulmonary TB with respiratory failure was Y=1.710 − 0.068*PaO 2 −0.163* albumin + 0.215* Apache II +0.012* C-reactive protein. The value was Y=−0.494. If the Y value was greater than or equal to −0.494, the patients belonged to the deceased group, and if less than −0.494 the patients belonged to the survival group. AUC=0.818, The sensitivity was 83.3%; specificity was 73.1%. Conclusions: Pulmonary TB patients with respiratory failure have a high mortality rate and poor prognosis, particularly those with high Apache II scores, high C-reactive protein levels, low PaO 2 admission to ICU and low albumin level. The prediction model will help assess the risk of death in patients with TB and respiratory failure.

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Section: Mortality Risk Factors Of Tb Patients With Respiratory Failure During Icu Treatmentsupporting

confidence: 44%

Prediction model for death in patients with pulmonary tuberculosis accompanied by respiratory failure in ICU: retrospective study

et al. 2020

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“…A certain false negative rate had been found in IGRA among patients with tuberculosis especially in HIV infected individuals [8]. In addition, older age, non-Hispanic white race/ethnicity, being tested with T-SPOT.TB, albumin-globulin ratio, CD4+ and CD8+ had been think as the factors for TB-IGRA diagnosis in previous studies [8,9]. In HIV infected patients without active TB, TB-IGRA assay with MTB specific antigens were negatively correlated to numbers of circulating CD4+ T-cells, and was influenced by the degree of immunodeficiency [10].…”

Section: Introductionmentioning

confidence: 97%

The diagnostic performance of TB-IGRA on HIV infected patients with active tuberculosis is associated with CD4+ T-cell counts

Wang

Chen

Dong

et al. 2019

Preprint

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Objective: To investigate the factors associated with the diagnostic performance of interferon-gamma release assay (IGRA) in HIV infected patients with active tuberculosis (TB). Methods: We retrospectively analyzed the data of HIV infected patients with active tuberculosis patients from 2016-2019 who conformed with the inclusion criteria and the exclusion criteria. All patients included were performed with TB-IGRA. For evaluating the diagnostic performance of TB-IGRA, patients were divided into positive TB-IGRA and negative TB-IGRA groups. And all statistical analysis was performed using SPSS Results: Performed by logistic regression analysis, we found that CD4 cell counts is independent risk factor for false negative of TB-IGRA(P<0.001). Additionally, false negative of TB-IGRA were 68.75%, 24.29% and 14.63%, respectively, in the three groups whose CD4+ T cell counts were <20/μL, 20-100/μL and >100/μL, with the highest frequency in subjects with CD4+ T cell counts <20/μL(P<0.001). And false negative of TB-IGRA were 68.75%, 27.77%, 20.58% and 14.63%, respectively, in the four groups <20/μL (n = 32), 20-50/μL (n = 36) ,51-100/μL (n = 34) and >100/μL (n = 82). The group of CD4+ T cell counts <20/μL had the highest false negative (P<0.001). There was no significant difference in the groups of 20-50/μL, 51-100/μL and >100/μL (P=0.483, P=0.623, respectively). Conclusion: The low level of CD4+ T-cell counts increase false negative TB-IGRA in HIV infected patients with active tuberculosis. These data suggest IGRA assays may have unreliable diagnostic performance results among patients with advanced HIV especially CD4+ T cell counts were <20/μL.

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“…The false negative of IGRA had been found in some TB patients especially combined HIV infection [8]. In addition, older age, non-Hispanic white race/ethnicity, being tested with T-SPOT.TB, albumin-globulin ratio, CD4 + T cell counts and CD8 + T cell counts had been thought as the in uencing factors of TB-IGRA diagnostic performance in previous studies [8,9]. In HIV infected patients, diagnostic performance of TB-IGRA(QFT-G-IT immune responses) was negatively correlated with circulating CD4 + T cell counts, and was in uenced by the degree of immunode ciency [10].…”

Section: Introductionmentioning

confidence: 99%

The diagnostic performance of TB-IGRA on HIV infected patients with active tuberculosis is associated with CD4+ T-cell counts

Wang

Zhou

Chen

et al. 2020

Preprint

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Abstract Background To investigate the factors associated with the diagnostic performance of interferon-gamma release assay (IGRA) on HIV infected patients with active tuberculosis (TB). Methods We retrospectively collected and analyzed the data of HIV infected patients with active tuberculosis hospitalized in Xixi Hospital of Hangzhou and Ruian people’s hospital of Wenzhou from January 1, 2016 to September 1, 2019. TB-IGRA was performed on all patients. For evaluating the diagnostic performance of TB-IGRA, all patients were divided into TB-IGRA positive group and TB-IGRA negative group. Results Among 184 patients, 133 patients were TB-IGRA positive and 51 patients were TB-IGRA negative. Performed by logistic regression analysis, we found that CD4+ T cell counts were an independent risk factor for false negative of TB-IGRA (OR=1.006, 95%CI 1.003-1.010, P<0.001). Additionally, the false negative rates of TB-IGRA were 68.75%, 27.77%, 20.58% and 14.63%, respectively, in the four groups whose CD4+ T cell counts were <20/μL (group 1, n=32), 20-50/μL (group 2, n=36), 51-100/μL (group 3, n=34) and >100/μL (group 4, n=82). The group 1 had the highest false negative rate, compared with other groups (P<0.001). However, there was no significant difference of the false negative rate between group 2 and 3 (P=0.483), group 3 and 4 (P=0.623). Conclusions The low level of CD4+ T cell counts could increase the false negative rate of TB-IGRA in HIV infected patients with active tuberculosis. And TB-IGRA may have unreliable diagnostic performance on HIV patients with active tuberculosis, especially when CD4+ T cell counts were <20/μL.

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Quantitative investigation of factors relevant to the T cell spot test for tuberculosis infection in active tuberculosis

Cited by 5 publications

References 36 publications

Prediction model for death in patients with pulmonary tuberculosis accompanied by respiratory failure in ICU: retrospective study

Prediction model for death in patients with pulmonary tuberculosis accompanied by respiratory failure in ICU: retrospective study

The diagnostic performance of TB-IGRA on HIV infected patients with active tuberculosis is associated with CD4+ T-cell counts

The diagnostic performance of TB-IGRA on HIV infected patients with active tuberculosis is associated with CD4+ T-cell counts

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