Latent tuberculosis detection by interferon γ release assay during pregnancy predicts active tuberculosis and mortality in human immunodeficiency virus type 1-infected women and their children.
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Date
2010-12Author
Jonnalagadda, S
Lohman, Payne B
Brown, E
Wamalwa, D
Maleche, Obimbo E
Majiwa, M
Farquhar, C
Otieno, P
Mbori-Ngacha, D
Type
ArticleLanguage
enMetadata
Show full item recordAbstract
BACKGROUND:
We evaluated the prognostic usefulness of interferon γ release assays (IGRAs) for active tuberculosis and mortality in Kenyan human immunodeficiency virus type 1 (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 cell count (aHR(CD4)), were calculated for associations between IGRA positivity and risk of active tuberculosis and mortality over 2-year postpartum follow-up among women and their infants.
RESULTS:
Of 333 women tested, 52 (15.6%) had indeterminate IGRA results. Of the remaining 281 women, 120 (42.7%) had positive IGRA results, which were associated with a 4.5-fold increased risk of active tuberculosis (aHR(CD4), 4.5; 95% confidence interval [CI], 1.1-18.0; P = .030). For immunosuppressed women (CD4 cell count, <250 cells/μL), positive IGRA results were associated with increased risk of maternal mortality (aHR(CD4), 3.5; 95% CI, 1.02-12.1;), maternal active tuberculosis or mortality (aHR(CD4), 5.2; 95% CI, 1.7-15.6; P = .004), and infant active tuberculosis or mortality overall (aHR(CD4), 3.0; 95% CI, 1.0-8.9; P = .05) and among HIV-1-exposed uninfected infants (aHR(CD4), 7.3; 95% CI, 1.6-33.5; P = .01).
CONCLUSIONS:
Positive IGRA results for HIV-1-infected pregnant women were associated with postpartum active tuberculosis and mortality among mothers and their infants.
URI
http://www.ncbi.nlm.nih.gov/pubmed/21067370http://erepository.uonbi.ac.ke:8080/xmlui/handle/123456789/39126
Citation
J Infect Dis. 2010 Dec 15;202(12):1826-35Publisher
University of Nairobi. Department of Paediatrics
Collections
- Faculty of Health Sciences (FHS) [10377]