An observational study identifying highly tuberculosis-exposed, HIV-1-positive but persistently TB, tuberculin and IGRA negative persons with M. tuberculosis specific antibodies in Cape Town, South Africa

一项观察性研究,确定了南非开普敦结核病暴露率高、HIV-1 阳性但持续结核病、结核菌素和 IGRA 阴性且具有结核分枝杆菌特异性抗体的人

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作者:Elouise E Kroon, Craig J Kinnear, Marianna Orlova, Stephanie Fischinger, Sally Shin, Sihaam Boolay, Gerhard Walzl, Ashley Jacobs, Robert J Wilkinson, Galit Alter, Erwin Schurr, Eileen G Hoal, Marlo Möller

Background

Mycobacterium tuberculosis (Mtb) infection is inferred from positive

Methods

A community-based case-control design was used to systematically screen and identify adults living with HIV (HIV+), aged 35-60 years, who met stringent study criteria, and then longitudinally followed up for repeat IGRA and TST testing. Participants had no history of TB despite living in TB hyper-endemic environments in Cape Town, South Africa with a provincial incidence of 681/100,000. Mtb-specific antibodies were measured using ELISA and Luminex. Findings: We identified 48/286 (17%) individuals who tested persistently negative for Mtb-specific T-cell immunoreactivity (three negative Quantiferon

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