Impact of HIV and peripartum period on Mycobacterium tuberculosis infection detection
Date
2023Author
Escudero, Jaclyn N
Mecha, Jerphason
Richardson, Barbra A
Elizabeth, Maleche-Obimbo
Matemo, Daniel
Kinuthia, John
John-Stewart, Grace
LaCourse, Sylvia M
Type
ArticleLanguage
enMetadata
Show full item recordAbstract
Background: Pregnancy and HIV may influence TB infection (TBI) detection using interferon gamma-release assays (QFT-Plus) and tuberculin skin tests (TST).
Methods: Participants from antenatal clinics in Western Kenya underwent QFT-Plus and TST in pregnancy, 6-weeks (6wkPP) and 12-months postpartum (12moPP).
Results: 400 participants (200 WHIV/200 HIV-negative) enrolled in pregnancy at median 28 weeks gestation (IQR 24-30).QFT-Plus + prevalence was higher than TST + in pregnancy (32.5% vs. 11.6%) and through 12moPP (6wkPP: QFT-Plus 30.9% vs. TST 18.0%, 12moPP: QFT-Plus 29.5% vs. TST 17.1%, all p < 0.001), driven primarily QFT-Plus+/TST- discordance among HIV-negative women.TBI test conversion incidence was 28.4/100PY, and higher in WHIV vs. HIV-negative women (35.5 vs. 20.9/100PY, HR 1.73 [95%CI 1.04-2.88]), mostly due to early postpartum TST conversion among WHIV.Among QFT-Plus + participants in pregnancy, Mtb-specific IFN-γ responses were dynamic from pregnancy to 12moPP and were lower among WHIV vs. HIV-negative women with TBI at all time points.
Conclusions: QFT-Plus had higher TBI diagnostic yield than TST in peripartum women with/without HIV. Peripartum QFT-Plus + prevalence was stable and less influenced by HIV than TST. Mtb-specific IFN-γ responses were dynamic and lower among WHIV. TBI test conversion incidence was high between pregnancy and early postpartum, potentially due to postpartum immune recovery.
Citation
Escudero JN, Mecha J, Richardson BA, Maleche-Obimbo E, Matemo D, Kinuthia J, John-Stewart G, LaCourse SM. Impact of HIV and peripartum period on Mycobacterium tuberculosis infection detection. J Infect Dis. 2023 Sep 28:jiad416. doi: 10.1093/infdis/jiad416. Epub ahead of print. PMID: 37768184.Publisher
University of Nairobi
Rights
Attribution-NonCommercial-NoDerivs 3.0 United StatesUsage Rights
http://creativecommons.org/licenses/by-nc-nd/3.0/us/Collections
- Faculty of Health Sciences (FHS) [10378]
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