Low prevalence of positive interferon-gamma tests in HIV-positive long-term immigrants in Norway

N D Pullar; H Steinum; K Tonby; L Heggelund; R A Leiva; R Ofstad; J N Bruun; A M Dyrhol-Riise

doi:10.5588/ijtld.13.0276

Low prevalence of positive interferon-gamma tests in HIV-positive long-term immigrants in Norway

Int J Tuberc Lung Dis. 2014 Feb;18(2):180-7. doi: 10.5588/ijtld.13.0276.

Authors

N D Pullar¹, H Steinum², K Tonby³, L Heggelund⁴, R A Leiva⁵, R Ofstad⁶, J N Bruun¹, A M Dyrhol-Riise⁷

Affiliations

¹ Department of Internal Medicine, Section for Infectious Diseases, University Hospital of Northern Norway, Tromsø, Norway; Department of Clinical Medicine, Faculty of Health Sciences, University of Tromsø, Tromsø, Norway.
² Department of Infectious Diseases, Trondheim University Hospital, Trondheim, Norway.
³ Department of Infectious Diseases, Oslo University Hospital (Ullevål), Nydalen, Oslo, Norway; Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway.
⁴ Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway; Section for Clinical Immunology and Infectious Diseases, Oslo University Hospital (Rikshospitalet), Nydalen, Oslo, Norway; Department of Medicine, Drammen Hospital, Vestre Viken Hospital Trust, Drammen, Norway.
⁵ Department of Medicine, Haukeland University Hospital, Bergen, Norway.
⁶ Department of Internal Medicine, Haugesund Hospital, Haugesund, Norway.
⁷ Department of Infectious Diseases, Oslo University Hospital (Ullevål), Nydalen, Oslo, Norway; Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway; Department of Medicine, Haukeland University Hospital, Bergen, Norway; and Department of Clinical Science, University of Bergen, Bergen, Norway.

PMID: 24429310
DOI: 10.5588/ijtld.13.0276

Abstract

Objective: To determine the prevalence and predictors of positive interferon-gamma release assays (IGRAs) and tuberculin skin tests (TSTs) in human immunodeficiency virus (HIV) infected patients in Norway, a low tuberculosis (TB) endemic country.

Design: Multicentre cross-sectional study of 298 HIV patients tested with QuantiFERON®-TB Gold In-Tube (QFT-GIT), T-SPOT®.TB (T-SPOT) and TST.

Results: A total of 77/298 (26%) QFT-GIT, 29/117 (25%) T-SPOT and 52/217 (24%) TSTs (≥ 5 mm) were positive. The median CD4 count was 427 cells/l. Three QFT-GIT results but no T-SPOT results were indeterminate. Of 52 TST-positive patients, 34 (65%) were QFT-GIT-positive (median interferon-gamma [IFN-] 4.38 international units [IU]/ml), compared to 16% of the TST-negative patients (median INF- 0.81 IU/ml, P < 0.001). Origin from a TB-endemic country, previous active TB and TB exposure were associated with a positive QFT-GIT (P 0.01). Patients from TB-endemic countries living in Norway for ≥ 10 years had lower odds of a positive QFT-GIT (12%; OR 0.17, 95%CI 0.060.53, P 0.002) than patients with 03 years' residence (49%).

Conclusion: The prevalence of positive IGRAs in HIV-infected patients was high in this low TB endemic setting. Lower QFT-GIT positivity in long-term residents from TB-endemic countries may reflect a waning of TB-specific immune responses.

Publication types

Comparative Study
Multicenter Study
Research Support, Non-U.S. Gov't

MeSH terms

Adult
Aged
CD4 Lymphocyte Count
Coinfection*
Cross-Sectional Studies
Emigrants and Immigrants*
Emigration and Immigration
Endemic Diseases*
Female
HIV Infections / diagnosis*
HIV Infections / ethnology*
HIV Infections / immunology
Humans
Interferon-gamma Release Tests* / methods
Male
Middle Aged
Norway / epidemiology
Predictive Value of Tests
Prevalence
Risk Factors
Time Factors
Tuberculin Test
Tuberculosis / diagnosis*
Tuberculosis / ethnology*
Tuberculosis / immunology
Tuberculosis / microbiology
Young Adult