Diagnostic value of TB-IGRA in AIDS patients with pulmonary tuberculosis and its correlation with CD4+T lymphocyte count
Objective To explore the diagnostic value of tuberculosis-interferon gamma release assay(TB-IGRA)in acquired immunodeficiency syndrome(AIDS)patients with pulmonary tuberculosis,and analyze the effect of different levels of CD4+T lymphocyte count on the diagnosis of TB-IGRA.Methods A cluster of 283 AIDS patients with suspected pulmonary tuberculosis admitted to the Second Hospital of Nanjing from January 2019 to December 2022 was selected as the study object.According to clinical diagnosis,111 patients with AIDS and pulmonary tuberculosis were included in the combined group,and 172 patients with simple AIDS were included in the simple group.Both groups of patients were tested for TB-IGRA,and tuberculosis antibody(TB-Ab).CD4+T lymphocyte count in peripheral blood was measured by flow cytometry.Results The positive rate of TB-IGRA in the combined group was 75.68％,which was significantly higher than that in the simple group(15.12％)(x2=104.127,P＜0.001);The positive rates of TB-Ab in the combined group and the simple group were 27.93％and 20.35％,respectively,with no significant difference(x2=2.167,P=0.141).In the combined group,the sensitivity,positive predictive value,negative predictive value and diagnostic accuracy of TB-IGRA test were 75.68％,76.36％,84.39％and 81.27％respectively,which were higher than those of TB-Ab test(27.93％,46.97％,63.13％,59.36％),the difference was significant(all P＜0.05),and there was no significant difference between the specificity of the two methods(x2=1.614,P=0.204).The positive rate of TB-IGRA in the combined group when CD4+T lymphocyte count ≥200 cell/μL(92.59％)was significantly higher than that of CD4+T lymphocyte count＜200 cell/μL(70.24％)(x2=5.547,P=0.019).Conclusion TB-IGRA detection method had high diagnostic efficiency,and its sensitivity was affected by CD4+T lymphocyte count in peripheral blood,and CD4+T lymphocyte count≥200 cell/μ,L could improve the positive rate of TB-IGRA in AIDS patients with pulmonary tuberculosis.
AIDS complicated with pulmonary tuberculosisTB-IGRATuberculosis antibodyCD4+T lymphocyte count
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