Pairing QuantiFERON gold in-tube with opt-out HIV testing in a tuberculosis contact investigation in the Southeastern United States.
Abstract
Knowing one's HIV status is particularly important in the setting of recent tuberculosis
(TB) exposure. Blood tests for assessment of tuberculosis infection, such as the QuantiFERON
Gold in-tube test (QFT; Cellestis Limited, Carnegie, Victoria, Australia), offer the
possibility of simultaneous screening for TB and HIV with a single blood draw. We
performed a cross-sectional analysis of all contacts to a highly infectious TB case
in a large meatpacking factory. Twenty-two percent were foreign-born and 73% were
black. Contacts were tested with both tuberculin skin testing (TST) and QFT. HIV testing
was offered on an opt-out basis. Persons with TST >or=10 mm, positive QFT, and/or
positive HIV test were offered latent TB treatment. Three hundred twenty-six contacts
were screened: TST results were available for 266 people and an additional 24 reported
a prior positive TST for a total of 290 persons with any TST result (89.0%). Adequate
QFT specimens were obtained for 312 (95.7%) of persons. Thirty-two persons had QFT
results but did not return for TST reading. Twenty-two percent met the criteria for
latent TB infection. Eighty-eight percent accepted HIV testing. Two (0.7%) were HIV
seropositive; both individuals were already aware of their HIV status, but one had
stopped care a year previously. None of the HIV-seropositive persons had latent TB,
but all were offered latent TB treatment per standard guidelines. This demonstrates
that opt-out HIV testing combined with QFT in a large TB contact investigation was
feasible and useful. HIV testing was also widely accepted. Pairing QFT with opt-out
HIV testing should be strongly considered when possible.
Type
Journal articleSubject
AdultAged
Contact Tracing
Cross-Sectional Studies
Female
HIV Antibodies
HIV Infections
Humans
Interferon-gamma
Male
Middle Aged
Mycobacterium tuberculosis
Retrospective Studies
Southeastern United States
Tuberculin Test
Tuberculosis, Pulmonary
Viral Load
Young Adult
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http://hdl.handle.net/10161/3350Published Version (Please cite this version)
10.1089/apc.2010.0102Publication Info
Baker, AV; Bissette, Deborah J; Chen, L; Cox, GM; Erlandson, K; Gadkowski, LB; ... Turner, DS (2010). Pairing QuantiFERON gold in-tube with opt-out HIV testing in a tuberculosis contact investigation in the Southeastern United States. AIDS Patient Care STDS, 24(9). pp. 539-543. 10.1089/apc.2010.0102. Retrieved from http://hdl.handle.net/10161/3350.This is constructed from limited available data and may be imprecise. To cite this
article, please review & use the official citation provided by the journal.
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Show full item recordScholars@Duke
Susanna Naggie
Associate Professor of Medicine
Jason Eric Stout
Professor of Medicine
My research focuses on the epidemiology, natural history, and treatment of tuberculosis
and nontuberculous mycobacterial infections. I am also interested in the impact of
HIV infection on mycobacterial infection and disease, and in examining health disparities
as they relate to infectious diseases, particularly in immigrant populations.
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