Comparison of QuantiFERON Gold In-Tube Versus Tuberculin Skin Tests on the Initiation of Tuberculosis Preventive Therapy Among Patients Newly Diagnosed With Human Immunodeficiency Virus in the North West Province of South Africa (the Teko Study): A Cluster Randomized Trial

被引：0

作者：

Jarrett, Brooke A. ^{[1
]}

Shearer, Kate ^{[2
]}

Motlhaoleng, Katlego ^{[3
]}

Chon, Sandy ^{[2
]}

Letuba, Gaolaolwe Gabriel ^{[3
]}

Qomfo, Cokiswa ^{[3
]}

Moulton, Lawrence H. ^{[2
,4
]}

Cohn, Silvia ^{[2
]}

Lebina, Limakatso ^{[3
]}

Chaisson, Richard E. ^{[2
,4
]}

Variava, Ebrahim ^{[5
]}

Martinson, Neil A. ^{[2
,3
]}

Golub, Jonathan E. ^{[1
,2
,4
]}

机构：

[1] Johns Hopkins Univ, Bloomberg Sch Publ Hlth, Dept Epidemiol, Baltimore, MD USA

[2] Johns Hopkins Univ, Ctr TB Res, Sch Med, Baltimore, MD USA

[3] Univ Witwatersrand, Perinatal HIV Res Unit, Soweto, South Africa

[4] Johns Hopkins Univ, Bloomberg Sch Publ Hlth, Dept Int Hlth, Baltimore, MD USA

[5] Klerksdorp Tshepong Hosp Complex, Dept Internal Med, Klerksdorp, South Africa

来源：

CLINICAL INFECTIOUS DISEASES | 2024年 / 79卷 / 03期

关键词：

latent tuberculosis; prevention and control; interferon-gamma release tests; tuberculin test; HIV; LATENT TUBERCULOSIS; IMPLEMENTATION; INFECTION; CASCADE; CARE;

D O I：

10.1093/cid/ciae268

中图分类号：

R392 [医学免疫学]; Q939.91 [免疫学];

学科分类号：

100102 ;

摘要：

Background. Tuberculosis (TB) preventive therapy (TPT) reduces the risk of TB disease in people with human immunodeficiency virus (HIV), yet uptake has been suboptimal in many countries. We assessed whether QuantiFERON Gold In-Tube (QGIT) during routine HIV care increased TB infection (TBI) testing and TPT prescriptions. Methods. This parallel-arm, 1:1 cluster-randomized controlled trial compared the standard-of-care tuberculin skin test to QGIT in South Africa. We enrolled consenting, TPT-eligible adults diagnosed with HIV <= 30 days prior and used intention-to-treat analyses for the outcomes: proportion of patients with documented TBI results, proportion with documented TPT, and time from enrollment to outcomes. Findings. We enrolled 2232 patients across 14 clinics from November 2014 to May 2017 (58% in intervention clinics). At 24 months of follow-up, more participants in intervention clinics had TBI results (69% vs 2%, P < .001) and TPT prescriptions (45% vs 30%, P = .13) than control clinics. Controlling for baseline covariates, intervention clinics had 60% (95% confidence interval, 51-68; P < .001) more participants with TBI results and 12% (95% confidence interval, -6 to 31; P = .18) more with TPT prescriptions. Among participants with results, those in intervention clinics received results and TPT faster (intervention: median of 6 and 29 days after enrollment vs control: 21 and 54 days, respectively). Interpretation. In this setting, QGIT in routine HIV care resulted in more patients with TBI results. Clinicians also initiated more people with HIV on TPT in QGIT intervention clinics, and did so more quickly, than the control arm. Clinical Trials Registration. NCT02119130.

引用

页码：751 / 760

页数：10