The use of the ELISPOT technological platform in the diagnosis of tuberculosis infection in patients with HIV infection

Abstract

Introduction. The problem of the steady growth of HIV-associated tuberculosis has become more and more urgent in recent years in Russia. Diagnosis of tuberculosis is especially difficult at the stage of severe immunodeficiency.

Aim of the study - to assess the possibility of using the T-SPOT.TB method in the diagnosis of tuberculosis infection in patients with HIV infection.

Material and methods. In the period for 2019-2020, an analysis of the T-SPOT.TB results was carried out in 396 patients. The inclusion criteria for this study were age 18 and older, diagnosis of HIV infection, dispensary observation at the AIDS center, CT scan of the lungs, and the presence of a blood test for T-SPOT.TB. Based on the results of the T-SPOT.TB test, 2 groups were formed: group 1 - with a positive result - T-SPOT.TB+ (n = 143) and group 2 with a negative result - T-SPOT.TB- (n = 253).

Results. Tuberculosis was verified by detection of Mycobacterium tuberculosis in 117 patients with HIV-infection, all CT changes characteristic of tuberculosis, a positive T-SPOT. TB result was in 88 % (n = 103) cases. The mean CD4+ T cells level in this group was 230.05 ± 15.3 cell/mcl, 95 % CI [190.91- 256.2]. The diagnosis «latent tuberculosis infection» was made in 40 patients with HIV infection with a positive T-SPOT.TB result in the absence of changes on CT.

Conclusion. T-SPOT.TB can be used in a diagnostic complex for monitoring patients with HIV infections as a screening method that allows not only to verify the diagnosis in the future, but also to reveal latent tuberculosis.

Keywords:T-SPOT.TB; tuberculosis; mycobacteria; diagnostics; HIV infection

For citation: Borodulina E.A., Kudlay D.A., Kuznetsova A.N., Gladunova E.P, Kalashnikova E.V. The use of the ELISPOT technological platform in the diagnosis of tuberculosis infection in patients with HIV infection. Immu-nologiya. 2021; 42 (4): 395-402. DOI: https://doi.org/10.33029/0206-4952-2021-42-4-395-402 (in Russian)

Funding. The study had no sponsor support.

Conflict of interests. Authors declare no conflict of interests.

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