Table 3. Performance of TST and various IGRAs in HIV infected individuals without evidence of active TB infection.
| Country | Subject | Assay | No. | TST +/Total tested | TST not read (%) | IGRA +/Total tested | Indeterminate IGRA (%) | Kappa | p-value* | ||
|---|---|---|---|---|---|---|---|---|---|---|---|
| No. (%) | 95% CI | No. (%) | 95% CI | ||||||||
| Countries with low TB prevalence | |||||||||||
| France23 | Adults | QFTGT | 415 | 66/415 (16) | 13–20 | 0 (0) | 43/415 (10) | 8–14 | 23 (6) | 0.27 | NA |
| TS.TB | 34/415 (8) | 6–11 | 10 (2) | 0.30 | NA | ||||||
| USA24 | Adults | QFTGT | 294 | 19/205 (9) | 6–14 | 89 (30) | 25/294 (8) | 6–12 | 15 (5) | 0.37 | 1.00 |
| USA25 | Adults | QFTGT | 207 | 13/201 (6) | 4–11 | 3 (1) | 11/201 (5) | 3–9 | 10 (5) | 0.38 | 0.79 |
| USA26 | Adults | QFTGT | 578 | 18/533 (3) | 2–5 | NA | 26/553 (5) | 3–7 | NA | 0.15 | 0.18 |
| USA27 | Adults | QFTGT | 336 | 7/278 (2) | 1–5 | 58 (17) | 9/336 (3) | 1–5 | 6 (2) | 0.23 | 0.77 |
| TS.TB | 14/336 (4) | 2–7 | 47 (14) | 0.16 | 0.18 | ||||||
| Italy28 | Adults | QFTGT | 133 | 6/116 (5) | 2–11 | 17 (13) | 5/116 (4) | 2–10 | 7 (6) | 0.52 | NA |
| TS.TB | 4/116 (3) | 1–8 | 0 (0) | 0.16 | NA | ||||||
| Spain29 | Adults | QFTGT | 75 | 9/75 (12) | 6–21 | 0 (0) | 5/75 (7) | 3–15 | 1 (1) | 0.37 | NA |
| TS.TB | 7/75 (9) | 5–18 | 1 (1) | 0.02 | NA | ||||||
| Spain30 | Adults | QFTGT | 167 | 9/135 (7) | 4–12 | NA | 13/135(10) | 6–16 | 2 (1) | 0.60 | 0.28 |
| Chile31 | Adults | QFTGT | 116 | 12/110 (11) | 6–18 | 5 (4) | 17/115 (15) | 9–22 | 0 (0) | 0.59 | 0.05 |
| Germany32 | Adults | QFTG | 286 | 33/275 (12) | 9–16 | 11 (4) | 52/275 (19) | 15–24 | 1 (0.4) | 0.33 | NA |
| TS.TB | 66/275 (24) | 19–29 | 8 (3) | 0.20 | NA | ||||||
| Switzerland33 | Adults | TS.TB | 85 | 5/85 (6) | 2–13 | 0 (0) | 9/85 (10) | 6–19 | 8 (9) | 0.69 | NA |
| USA34 | Adults | QFT | 167 | 16/167 (10) | 6–15 | 0 (0) | 32/167 (19) | 14–26 | 0 (0) | 0.28 | <0.01† |
| USA35 | Adults | QFT | 34 | 9/34 (26) | 15–43 | 0 (0) | 17/34 (50) | 34–66 | 0 (0) | 0.41 | 0.02† |
| Italy15 | Adults | IHE | 66 | 16/66 (24) | 16–36 | 0 (0) | 3/66 (4) | 2–12 | 12 (18) | 0.11 | NA |
| Countries with high TB prevalence | |||||||||||
| India36 | Adults‡ | QFTGT | 252 | 27/252 (11) | 7–15 | 12 (5) | 71/252 (28) | 23–34 | 8 (3) | 0.25 | <0.005 |
| South Africa37 | Children | QFTGT | 93/299 (31) | 26–37 | 4 (1) | 59/299 (20) | 16–25 | 28 (9) | 0.50 | NA | |
| TS.TB | 39/297 (13) | 10–17 | 34 (11) | 0.45 | NA | ||||||
| Uganda38 | Adults | QFTGT | 109 | 42/89 (47) | 37–57 | 20 (18) | 74/109 (68;) | 59–76 | 4 (4) | 0.34 | NA |
| TS.TB | 59/109 (54) | 45–63 | 4 (4) | 0.37 | |||||||
| South Africa39 | Adults | QFTG | 74 | 35/67 (52) | 40–64 | 7 (9) | 32/74 (43) | 32–54 | 5 (7) | 0.58 | NA |
| TS.TB | 38/74 (51) | 40–62 | 1 (1) | 0.60 | |||||||
| South Africa40 | Adults | QFTG | 20 | 10/16 (62) | 39–82 | 4 (20) | 6/20 (30) | 14–52 | 3 (15) | 0.46 | NA |
| TS.TB | 13/20 (65) | 43–82 | 2 (10) | 0.43 | |||||||
| South Africa40 | Children | QFTG | 23 | 6/23 (26) | 12–46 | 0 (0) | 2/12 (17) | 5–45 | 0 (0) | 0.44 | NA |
| TS.TB | 12/23 (52) | 33–71 | 0 (0) | −0.02 | |||||||
| Trinidad and Tobago41 | Adults | QFTG | 70 | 12/64 (19) | 11–30 | 0 (0) | 26/70 (37) | 27–49 | 6 (8) | NA | NA |
| China21 | Adults | TS.TB | 68 | 28/68 (41) | 30–53 | 0 (0) | 46/68 (68) | 59–78 | 0 (0) | NA | NA |
| China42 | Adults | TS.TB | 93 | 3/93 (3) | 1–9 | 0 (0) | 16/93 (17) | 11–26 | 0 (0) | NA | NA |
| IHE | 19/93 (20) | 13–30 | 0 (0) | 0.23 | NA | ||||||
| Zimbabwe43 | Adults | TS.TB | 73 | 33/73 (45) | 34–56 | 0 (0) | 22/73 (30) | 21–41 | 0 (0) | 0.40 | 0.03† |
| Zambia44 | Adults | IHE | 21 | 5/14 (36) | 16–61 | 7 (33) | 9/21 (43) | 24–63 | 0 (0) | 0.25 | 1.00 |
| South Africa22 | Children | IHE | 79 | 7/48 (14) | 7–27 | 31 (39) | 20/79 (25) | 17–36 | 5 (6) | 0.12 | 0.06 |
| Senegal45 | Adults | IHE | 285 | 61/285 (21) | 17–26 | 0 (0) | 125/285 (44) | 38–50 | 38 (13) | 0.23 | NA |
Detailed description of methodological differences between studies in Table 4.
*McNemars test. †Statistically significant. ‡Pregnant women.
TST: tuberculin skin test; IGRA: interferon-γ release assay; HIV: human immunodeficiency virus; TB: tuberculosis; QFTGT: QuantiFERON Gold in Tube; TS.TB: T-SPOT.TB; NA: not available; QFTG: QuantiFERON Gold; QFT: QuantiFERON; IHE: in house ELISPOT assay.