AEGiS-14IAC: In vitro IFN- [gamma] production in whole blood culture in response to mycobacterial antigens in HIV/AIDS Bulgarian patients.

14th International AIDS Conference

Barcelona, Spain - July 7-12, 2002

In vitro IFN- [gamma] production in whole blood culture in response to mycobacterial antigens in HIV/AIDS Bulgarian patients.

Int Conf AIDS 2002 Jul 7-12; 14:(abstract no. B10247)

Markova R, Kostov K, Stefanova D, Terzieva V, Todorova Y, Taskov H, Valkova I
National Center of Infectious and Parasitic Diseases, Sofia 1504, Bulgaria

BACKGROUND: During last decades mycobacterial infections have been increasing in pts with advanced HIV-1 disease and their poor detection is a great problem. Tuberculin skin anergy as a manifestation of severe immune deficiency in AIDS pts is the main cause for false negative TST results. The aim of this study was by using the WB IFN-γ EIA to detect mycobacterial infections in HIV/AIDS pts .

METHODS: 52 HIV-1 seropositives (30 men aged 22-58 and 22 women aged 18-54 years), suspicious for mycobacterial infection were included. According to WHO classification pts were as follows:9 (17.4%)-A1, 4 (7,6%)-A2, 7 (13,5%)-A3, 3 (5,7%)-B1, 2 (3,8%)-B2, 8 (15,4%)-B3, 2 (3,9%)-C1 and 17 (32,7%)-C3. The commercially available QuantiFERON-TB é « (QF-TB) test (Cellestis) with 4 stimuli: PPD M.tuberculosis, PPD M.bovis, PPD M.avium, PHA as a positive and PBS as a negative control was used. A positive result was defined as a percent response level of >15% for M.tuberculosis and M.bovis and >20% - for M.avium. Statistical analysis was done by Mann-Whitney rank sum test and Spearman's rank test.

RESULTS:7 (41,17 %) of the 17 AIDS pts with strongly suppressed CMI demonstrated a positive in vitro response to PPD M.avium as measured by the specific INF-[gamma] production. In 5 (29,41%) of the rest AIDS pts, a positive response to PPD M.tuberculosis was found. Of the 20 asymptomatic pts only one (5%) in A3 stage, was positive for M.tuberculosis and no one - for M.avium. A weak correlation (r=0,4) between the specific IFN-γ production and the TST was observed in all pts.

CONCLUSIONS: Our results demonstrate a relatively high incidence of M.avium infection among AIDS pts. The high sensitivity and specificity of the QF-TB test makes it a very useful tool for the diagnosis of mycobacterial infections in HIV/AIDS pts. Further studies concerning the application of the QF-TB test for monitoring of anti-TB therapy are in progress.

Keywords: AEGIS, Tuberculin, Acquired Immunodeficiency Syndrome, HIV Infections, Tuberculosis, Tuberculin Test, Culture, HIV Seropositivity, Sensitivity and Specificity, Laboratory Techniques and Procedures, Skin Tests, Human, Female, Male, In Vitro, Economics, ethnology, immunology

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B10247