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    Pairing QuantiFERON gold in-tube with opt-out HIV testing in a tuberculosis contact investigation in the Southeastern United States.

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    Date
    2010-09
    Authors
    Baker, AV
    Bissette, Deborah J
    Chen, L
    Cox, GM
    Erlandson, K
    Gadkowski, LB
    Goswami, ND
    Lalani, T
    Naggie, Susanna
    Person, AK
    Stout, Jason Eric
    Turner, DS
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    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 article
    Subject
    Adult
    Aged
    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
    Permalink
    http://hdl.handle.net/10161/3350
    Published Version (Please cite this version)
    10.1089/apc.2010.0102
    Publication 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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    Scholars@Duke

    Naggie

    Susanna Naggie

    Associate Professor of Medicine
    Stout

    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.
    Alphabetical list of authors with Scholars@Duke profiles.
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