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Accuracy of the interferon-γ release assay for the diagnosis of active tuberculosis among HIV-seropositive individuals: a systematic review and meta-analysis

Overview of attention for article published in BMC Infectious Diseases, July 2016
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Title
Accuracy of the interferon-γ release assay for the diagnosis of active tuberculosis among HIV-seropositive individuals: a systematic review and meta-analysis
Published in
BMC Infectious Diseases, July 2016
DOI 10.1186/s12879-016-1687-8
Pubmed ID
Authors

Zhen-yu Huo, Li Peng

Abstract

Although the interferon-γ release assay (IGRA) has become a widely accepted means for the diagnosis of latent tuberculosis infection (LTBI), the role of the IGRA in diagnosing active tuberculosis (ATB) among human immunodeficiency virus (HIV)-seropositive individuals remains controversial. Previous analyses did not set up rational inclusive criteria for screening articles with strict control groups and a gold standard for ATB diagnosis. Therefore, we conducted a systematic review of the latest evidence to evaluate the accuracy of IGRA for HIV-seropositive patients. Initially, we searched the EMBASE, Cochrane and MEDLINE databases to find research articles published from January 2000 to October 2015 that used the QuantiFERON-TB Gold In-Tube assay (QFT-IT) or the T-SPOT.TB assay (T-SPOT) to diagnose ATB among HIV-seropositive individuals. We separately calculated the pooled sensitivity, specificity, and proportion of indeterminate events and then summarized the results using forest plots to estimate the accuracy of the QFT-IT and T-SPOT assays. A total of 1,743 studies were discovered after searching; 11 studies met our selection standards and were included for meta-analysis. The pooled sensitivity and specificity of the QFT-IT assay were 69 % (95 % CI, 50-84 %, I(2) = 85.22 %) and 76 % (95 % CI, 53-90 %, I(2) = 98.16 %), respectively, and the optimum area under the curve (AUC) was 0.78 (95 % CI, 0.74-0.82). The pooled sensitivity and specificity of the T-SPOT assay were 89 % (95 % CI, 66-97 %, I(2) = 94.48 %) and 87 % (95 % CI, 38-99 %, I(2) = 97.92 %), respectively, and the AUC was 0.93 (95 % CI, 0.90-0.95). The pooled ratios of the indeterminate results of the QFT-IT and T-SPOT assays were 0.07 (95 % CI, 0.06-0.09, I(2) = 74.8 %) and 0.19 (95 % CI, 0.15-0.24, I(2) = 88.3 %), respectively, calculated using the fixed effect model, and 0.08 (95 % CI, 0.06-0.12, I(2) = 74.8 %) and 0.10 (95 % CI, 0.03-0.25, I(2) = 88.3 %), respectively, calculated using the random effects model. The IGRA does not appear to be optimal for the clinical confirmation of ATB cases in HIV-seropositive patients; however, the T-SPOT assay may have greater accuracy in distinguishing ATB cases among HIV-infected individuals than the QFT-IT assay, while the QFT-IT assay appears to reduce the occurrence of indeterminate results. Furthermore, modification and additional trial designs are required to improve diagnostic effectiveness.

Twitter Demographics

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Mendeley readers

The data shown below were compiled from readership statistics for 30 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Unknown 30 100%

Demographic breakdown

Readers by professional status Count As %
Researcher 6 20%
Student > Master 5 17%
Student > Ph. D. Student 5 17%
Other 4 13%
Unspecified 3 10%
Other 7 23%
Readers by discipline Count As %
Medicine and Dentistry 13 43%
Unspecified 6 20%
Immunology and Microbiology 4 13%
Nursing and Health Professions 3 10%
Biochemistry, Genetics and Molecular Biology 2 7%
Other 2 7%

Attention Score in Context

This research output has an Altmetric Attention Score of 1. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 29 July 2016.
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#7,061,715
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Outputs from BMC Infectious Diseases
#3,326
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#217,692
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Outputs of similar age from BMC Infectious Diseases
#138
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