HIV/AIDS患者结核潜伏感染筛检试验效果评价  

Effectiveness of latent tuberculosis screening and testing for patients with HIV/AIDS

作　　者：陶娴 杨正贵 程亚龙 赵珊珊 刘兰[1,2] TAO Xian;YANG Zhenggui;CHENG Yalong;ZHAO Shanshan;LIU Lan(School of Public Health,Ningxia Medical University,Yinchuan 750004,Ningxia,China;Ningxia Key Laboratory of Environmental Factors and Chronic Disease Control,Yinchuan 750004,Ningxia,China;The Fourth People's Hospital of Ningxia Hui Autonomous Region,Yinchuan 750021,Ningxia,China)

机构地区：[1]宁夏医科大学公共卫生学院,银川750004 [2]宁夏环境因素与慢性病控制重点实验室,银川750004 [3]宁夏回族自治区第四人民医院,银川750021

出　　处：《中国艾滋病性病》2024年第1期61-64,共4页Chinese Journal of Aids & STD

基　　金：宁夏回族自治区重点研发计划项目(2020BEG03018);中国公共卫生联盟(第一批)课题(GWLM202021);自治区卫生健康委科研课题(2021-NW-031)。

摘　　要：目的探讨不同的检测试验在HIV/AIDS患者识别结核潜伏感染的能力,为高效识别结核潜伏感染(LTBI)提供科学可行的方法。方法通过重组结核杆菌融合蛋白(EC)、结核菌素皮肤试验(TST)和γ-干扰素释放试验(IGRA)筛查HIV/AIDS患者中LTBI的情况。以IGRA试验结果为标准,比较TST、EC试验的筛检效果。结果共筛查HIV/AIDS患者93例,其中IGRA、TST和EC试验的阳性率分别为10.8%(10/93)、22.6%(21/93)和12.9%(12/93)。TST试验的阳性率高于IGRA(P<0.05),EC试验的阳性率与IGRA试验的阳性率差异无统计学意义(P>0.05)。TST试验灵敏度为60.0%,特异度为81.9%。EC试验灵敏度为50.0%,特异度为91.6%。在灵敏度方面两种试验没有统计学差异,在特异度方面EC试验高于TST。TST与EC试验Kappa值为0.527,一致性中等。结论EC试验的阳性率比TST更能准确反映HIV/AIDS患者LTBI感染情况,EC试验特异度也优于TST,且其具有操作简便等优点。在HIV/AIDS患者人群中通过EC试验筛查LTBI是可行的,具有一定的应用价值。Objective This study explores the ability of different tests in identifying latent tuberculosis infection(LTBI)in patients with HIV/AIDS,and provides a scientific and feasible method for efficient identification of LTBI.Methods Recombinant Mycobacterium tuberculosis fusion protein(EC),tuberculin skin test(TST),andγ-interferon release assay(IGRA)were used to screen LTBI in patients with HIV/AIDS.Results of the IGRA were used as the standard to compare the screening effects of TST and EC test.Results A total of 93 individuals infected with HIV/AIDS were screened,with positive rates of 10.8%(10/93)for IGRA,22.6%(21/93)for TST,and 12.9%(12/93)for EC tests.The positive rate of the TST was higher than that of the IGRA(P<0.05),but no statistical difference was observed in the positive rate of the EC test and that of the IGRA(P>0.05).In addition,according to the results of the IGRA for detecting latent tuberculosis infection as the standard,the sensitivity of the TST was 60.0%and its specificity was 81.9%.The sensitivity of the EC test was 50.0%and its specificity was 91.6%.There was no statistically significant difference between the two tests in terms of sensitivity,while the EC test exhibited a higher specificity than the TST.Further,both the TST and EC tests had a Kappa value of 0.527,displaying medium conformity.The positive rate of the EC test reflects the prevalence of LTBI among patients with HIV/AIDS more accurately compared with the TST,and the specificity of EC test was also better than that of the TST.Conclusions EC test is easier to conduct,and screening for LTBI in the HIV/AIDS population using an EC test has certain application value.

关 键 词：重组结核杆菌融合蛋白 结核菌素皮肤试验 Γ-干扰素释放试验 结核潜伏感染 艾滋病 

分 类 号：R512.91[医药卫生—内科学] R52[医药卫生—临床医学]