Latent TB detection by interferon gamma release assay (IGRA) in pregnancy predicts active TB and mortality in HIV-1 infected women and their children
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Date
2010Author
Jonnalagadda, Sasi
Payne, Barbara Lohman
Brown, Elizabeth
Wamalwa, Dalton
Obimbo, Elizabeth Maleche
Majiwa, Maxwel
Farquhar, Carey
Otieno, Phelgona
Mbori-Ngacha, DA
John-Stewart, Grace
Type
ArticleLanguage
enMetadata
Show full item recordAbstract
Background—We evaluated the prognostic utility of interferon-gamma release assays (IGRAs)
for active tuberculosis (TB) and mortality in Kenyan HIV-1 infected women and their infants.
Methods—Prevalence and correlates of Mycobacterium tuberculosis-specific T-SPOT.TB IGRA
positivity were determined during pregnancy in a historical cohort of HIV-1 infected women.
Hazard ratios, adjusted for baseline maternal CD4 count (aHRCD4) were calculated for
associations between IGRA positivity and risk of active TB and mortality over 2-year postpartum
follow-up in women and their infants.
Results—Of 333 women tested, 52 (15.6%) had indeterminate IGRAs. Of the remaining 281
women, 120 (42.7%) had positive IGRAs, which were associated with a 4.5-fold increased risk of
active TB [aHRCD4: 4.5; 95% confidence interval (CI): 1.1–18.0; p=0.03]. Among
immunosuppresed women (CD4<250 cell/mm3), positive IGRAs were associated with increased
risk of maternal mortality (aHRCD4: 3.5; 95% CI: 1.02–12.1; p=0.045), maternal active TB or
mortality (aHRCD4: 5.2; 95% CI: 1.7–15.6; p=0.004) and infant active TB or mortality, overall
Citation
J Infect Dis.Publisher
6Department of Paediatrics, University of Nairobi, Nairobi, Kenya
Collections
- Faculty of Health Sciences (FHS) [10378]