{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,21]],"date-time":"2026-03-21T07:25:10Z","timestamp":1774077910815,"version":"3.50.1"},"reference-count":45,"publisher":"Oxford University Press (OUP)","issue":"12","license":[{"start":{"date-parts":[[2016,6,1]],"date-time":"2016-06-01T00:00:00Z","timestamp":1464739200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["U01 AI069497"],"award-info":[{"award-number":["U01 AI069497"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["T32 AI007613"],"award-info":[{"award-number":["T32 AI007613"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100020400","name":"Weill Cornell Clinical and Translational Science Center","doi-asserted-by":"publisher","award":["KL2 TR00458"],"award-info":[{"award-number":["KL2 TR00458"]}],"id":[{"id":"10.13039\/100020400","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2016,6,15]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Rationale<\/jats:title>\n                    <jats:p>Pregnant women with latent tuberculosis infection (LTBI) are at high risk for development of TB, especially if infected with HIV.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To assess the performance of LTBI tests in pregnant and postpartum women infected with HIV, investigate the immunology behind discordance in pregnancy, and explore the implications for the development of postpartum TB.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We screened pregnant women in their second\/third trimester and at delivery for LTBI using the tuberculin skin test (TST) and IFN-\u03b3 release assay (IGRA) (QuantiFERON Gold). A subset of antepartum women had longitudinal testing, with repeat testing at delivery and postpartum and additional cytokines measured from the IGRA supernatant. The kappa statistic and Wilcoxon rank sum test were used to determine agreement and comparison of cytokine concentrations, respectively.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Measurements and Main Results<\/jats:title>\n                    <jats:p>Of 252 enrolled, 71 (28%) women had a positive IGRA but only 27 (10%) had a positive TST (P\u2009&amp;lt;\u20090.005). There was 75% agreement (kappa, 0.25). When stratified by pregnancy versus delivery, 20% had IGRA+\/TST\u2212 discordance at each time point. A positive IGRA was associated with known TB contact (odds ratio, 3.6; confidence interval, 1.2\u201311.1; P\u2009=\u20090.02). Compared with IGRA+\/TST+, women with IGRA+\/TST\u2212 discordance had significantly less IFN-\u03b3 (1.85 vs. 3.48 IU\/ml; P\u2009=\u20090.02) and IL-2 (46.17 vs. 84.03 pg\/ml; P\u2009=\u20090.01). Five developed postpartum TB, of which three had IGRA+\/TST\u2212 discordance during pregnancy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Choice of LTBI test in pregnant women infected with HIV affects results. Pregnant women with IGRA+\/TST\u2212 discordance had less IFN-\u03b3 and IL-2 than those with concordant-positive results and may represent an especially high-risk subset for the development of active TB postpartum.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1164\/rccm.201508-1595oc","type":"journal-article","created":{"date-parts":[[2016,1,14]],"date-time":"2016-01-14T22:38:53Z","timestamp":1452811133000},"page":"1421-1428","source":"Crossref","is-referenced-by-count":40,"title":["Quantitative IFN-\u03b3 and IL-2 Response Associated with Latent Tuberculosis Test Discordance in HIV-infected Pregnant Women"],"prefix":"10.1093","volume":"193","author":[{"given":"Jyoti S.","family":"Mathad","sequence":"first","affiliation":[{"name":"Center for Global Health, Division of Infectious Diseases, Weill Cornell Medical College, New York, New York"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ramesh","family":"Bhosale","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology, Byramjee Jeejeebhoy Government Medical College\/Sassoon General Hospital, Pune, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Usha","family":"Balasubramanian","sequence":"additional","affiliation":[{"name":"Byramjee Jeejeebhoy Government Medical College-Johns Hopkins Clinical Trials Unit, Pune, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Savita","family":"Kanade","sequence":"additional","affiliation":[{"name":"Byramjee Jeejeebhoy Government Medical College-Johns Hopkins Clinical Trials Unit, Pune, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vidya","family":"Mave","sequence":"additional","affiliation":[{"name":"Byramjee Jeejeebhoy Government Medical College-Johns Hopkins Clinical Trials Unit, Pune, India"},{"name":"Division of Infectious Diseases, Johns Hopkins University School of Medicine, Baltimore, Maryland; and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nishi","family":"Suryavanshi","sequence":"additional","affiliation":[{"name":"Byramjee Jeejeebhoy Government Medical College-Johns Hopkins Clinical Trials Unit, Pune, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nikhil","family":"Gupte","sequence":"additional","affiliation":[{"name":"Byramjee Jeejeebhoy Government Medical College-Johns Hopkins Clinical Trials Unit, Pune, India"},{"name":"Division of Infectious Diseases, Johns Hopkins University School of Medicine, Baltimore, Maryland; and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Samir","family":"Joshi","sequence":"additional","affiliation":[{"name":"Byramjee Jeejeebhoy Government Medical College\/Sassoon General Hospital, Pune, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ajay","family":"Chandanwale","sequence":"additional","affiliation":[{"name":"Byramjee Jeejeebhoy Government Medical College\/Sassoon General Hospital, Pune, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kathryn M.","family":"Dupnik","sequence":"additional","affiliation":[{"name":"Center for Global Health, Division of Infectious Diseases, Weill Cornell Medical College, New York, New York"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vandana","family":"Kulkarni","sequence":"additional","affiliation":[{"name":"Byramjee Jeejeebhoy Government Medical College-Johns Hopkins Clinical Trials Unit, Pune, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Prasad","family":"Deshpande","sequence":"additional","affiliation":[{"name":"Byramjee Jeejeebhoy Government Medical College-Johns Hopkins Clinical Trials Unit, Pune, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniel W.","family":"Fitzgerald","sequence":"additional","affiliation":[{"name":"Center for Global Health, Division of Infectious Diseases, Weill Cornell Medical College, New York, New York"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Amita","family":"Gupta","sequence":"additional","affiliation":[{"name":"Byramjee Jeejeebhoy Government Medical College-Johns Hopkins Clinical Trials Unit, Pune, India"},{"name":"Division of Infectious Diseases, Johns Hopkins University School of Medicine, Baltimore, Maryland; and"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2016,6,15]]},"reference":[{"key":"2026032100073584400_bib1","doi-asserted-by":"crossref","first-page":"196","DOI":"10.1097\/QAI.0b013e3181900201","article-title":"Intensified case finding for tuberculosis in prevention of mother-to-child transmission programs: a simple and potentially vital addition for maternal and child health","volume":"50","author":"Deluca","year":"2009","journal-title":"J Acquir Immune Defic Syndr"},{"key":"2026032100073584400_bib2","volume-title":"Global tuberculosis report 2014","author":"World Health Organization","year":"2014"},{"key":"2026032100073584400_bib3","first-page":"241","article-title":"Group BJMC-JHUS. Postpartum tuberculosis incidence and mortality among HIV-infected women and their infants in Pune, India, 2002-2005","volume":"45","author":"Gupta","year":"2007","journal-title":"Nephrol Dial Transplant"},{"key":"2026032100073584400_bib4","doi-asserted-by":"crossref","first-page":"779","DOI":"10.1164\/rccm.201106-1083OC","article-title":"Risk of tuberculosis in pregnancy: a national, primary care-based cohort and self-controlled case series study","volume":"185","author":"Zenner","year":"2012","journal-title":"Am J Respir Crit Care Med"},{"key":"2026032100073584400_bib5","doi-asserted-by":"crossref","first-page":"1532","DOI":"10.1093\/cid\/cis732","article-title":"Tuberculosis in pregnant and postpartum women: epidemiology, management, and research gaps","volume":"55","author":"Mathad","year":"2012","journal-title":"Clin Infect Dis"},{"key":"2026032100073584400_bib6","doi-asserted-by":"crossref","first-page":"1552","DOI":"10.5588\/ijtld.13.0239","article-title":"Predictive value of interferon-gamma release assays for postpartum active tuberculosis in HIV-1-infected women","volume":"17","author":"Jonnalagadda","year":"2013","journal-title":"Int J Tuberc Lung Dis"},{"key":"2026032100073584400_bib7","doi-asserted-by":"crossref","first-page":"573","DOI":"10.1097\/QAI.0000000000000353","article-title":"The association between the ratio of monocytes: lymphocytes and risk of tuberculosis among HIV-infected postpartum women","volume":"67","author":"Naranbhai","year":"2014","journal-title":"J Acquir Immune Defic Syndr"},{"key":"2026032100073584400_bib8","first-page":"983","article-title":"The increasing burden of tuberculosis in pregnant women, newborns and infants under 6 months of age in Durban, KwaZulu-Natal","volume":"91","author":"Pillay","year":"2001","journal-title":"S Afr Med J"},{"key":"2026032100073584400_bib9","doi-asserted-by":"crossref","first-page":"e44","DOI":"10.1371\/journal.pmed.0050044","article-title":"An autopsy study of maternal mortality in Mozambique: the contribution of infectious diseases","volume":"5","author":"Men\u00e9ndez","year":"2008","journal-title":"PLoS Med"},{"key":"2026032100073584400_bib10","doi-asserted-by":"crossref","first-page":"2211","DOI":"10.1056\/NEJMra1213566","article-title":"Pregnancy and infection","volume":"370","author":"Kourtis","year":"2014","journal-title":"N Engl J Med"},{"key":"2026032100073584400_bib11","doi-asserted-by":"crossref","first-page":"1192","DOI":"10.1086\/522182","article-title":"Immune reconstitution syndrome and exacerbation of infections after pregnancy","volume":"45","author":"Singh","year":"2007","journal-title":"Clin Infect Dis"},{"key":"2026032100073584400_bib12","doi-asserted-by":"crossref","first-page":"e92308","DOI":"10.1371\/journal.pone.0092308","article-title":"Pregnancy differentially impacts performance of latent tuberculosis diagnostics in a high-burden setting","volume":"9","author":"Mathad","year":"2014","journal-title":"PLoS One"},{"key":"2026032100073584400_bib13","first-page":"S504","article-title":"Screening HIV-positive pregnant women for TB in India: tuberculin skin test (TST) vs. QuantiFERON(R) Gold In-tube (QGIT)","volume":"17","author":"Mathad","year":"2013","journal-title":"Int J Tuberc Lung Dis"},{"key":"2026032100073584400_bib14","author":"Mathad"},{"key":"2026032100073584400_bib15","volume-title":"Household food insecurity access scale (HFIAS) for measurement of household food access (v.3)","author":"Coates"},{"key":"2026032100073584400_bib16","doi-asserted-by":"crossref","first-page":"e1000391","DOI":"10.1371\/journal.pmed.1000391","article-title":"Development of a standardized screening rule for tuberculosis in people living with HIV in resource-constrained settings: individual participant data meta-analysis of observational studies","volume":"8","author":"Getahun","year":"2011","journal-title":"PLoS Med"},{"key":"2026032100073584400_bib17","year":"2009"},{"key":"2026032100073584400_bib18","doi-asserted-by":"crossref","first-page":"1273","DOI":"10.5588\/ijtld.13.0147","article-title":"Comparison of different methods and times for reading the tuberculin skin test","volume":"17","author":"Mor\u00e1n-Mendoza","year":"2013","journal-title":"Int J Tuberc Lung Dis"},{"key":"2026032100073584400_bib19","first-page":"S221","article-title":"This official statement of the American Thoracic Society was adopted by the ATS Board of Directors, July 1999. This is a Joint Statement of the American Thoracic Society (ATS) and the Centers for Disease Control and Prevention (CDC). This statement was endorsed by the Council of the Infectious Diseases Society of America. (IDSA), September 1999, and the sections of this statement","volume":"161","author":"Targeted tuberculin testing and treatment of latent tuberculosis infection","year":"2000","journal-title":"Am J Respir Crit Care Med"},{"key":"2026032100073584400_bib20","author":"Array","year":"2009"},{"key":"2026032100073584400_bib21","article-title":"India TB RNTCP Status Report","volume-title":"Central TB Division, Directorate General of Health Services","author":"Revised National Tuberculosis Control Program","year":"2011"},{"key":"2026032100073584400_bib22","doi-asserted-by":"crossref","first-page":"1088","DOI":"10.1097\/AOG.0b013e3182546aff","article-title":"Performance of an interferon-gamma release assay to diagnose latent tuberculosis infection during pregnancy","volume":"119","author":"Lighter-Fisher","year":"2012","journal-title":"Obstet Gynecol"},{"key":"2026032100073584400_bib23","doi-asserted-by":"crossref","first-page":"737","DOI":"10.1164\/rccm.200608-1088OC","article-title":"Comparison of an interferon-gamma release assay with tuberculin skin testing in HIV-infected individuals","volume":"175","author":"Luetkemeyer","year":"2007","journal-title":"Am J Respir Crit Care Med"},{"key":"2026032100073584400_bib24","doi-asserted-by":"crossref","first-page":"645","DOI":"10.1016\/j.ijid.2008.03.005","article-title":"A comparative study of two different methods for the detection of latent tuberculosis in HIV-positive individuals in Chile","volume":"12","author":"Balcells","year":"2008","journal-title":"Int J Infect Dis"},{"key":"2026032100073584400_bib25","doi-asserted-by":"crossref","first-page":"1363","DOI":"10.1097\/AOG.0b013e31823834a9","article-title":"Interferon gamma release assay compared with the tuberculin skin test for latent tuberculosis detection in pregnancy","volume":"118","author":"Worjoloh","year":"2011","journal-title":"Obstet Gynecol"},{"key":"2026032100073584400_bib26","author":"LaCourse","year":"2015"},{"key":"2026032100073584400_bib27","doi-asserted-by":"crossref","first-page":"159","DOI":"10.1038\/sj.jp.7210617","article-title":"Tuberculosis skin testing among HIV-infected pregnant women in Miami, 1995 to 1996","volume":"22","author":"Schulte","year":"2002","journal-title":"J Perinatol"},{"key":"2026032100073584400_bib28","doi-asserted-by":"crossref","first-page":"20","DOI":"10.1111\/j.1600-065X.2011.01002.x","article-title":"Gimme shelter: the immune system during pregnancy","volume":"241","author":"Munoz-Suano","year":"2011","journal-title":"Immunol Rev"},{"key":"2026032100073584400_bib29","doi-asserted-by":"crossref","first-page":"411","DOI":"10.1111\/j.1600-0897.2010.00889.x","article-title":"Peripheral blood cytokine profiling during pregnancy and post-partum periods","volume":"64","author":"Kraus","year":"2010","journal-title":"Am J Reprod Immunol"},{"key":"2026032100073584400_bib30","doi-asserted-by":"crossref","first-page":"317","DOI":"10.1046\/j.1365-2249.2000.01123.x","article-title":"Variations in cytokine mRNA expression during normal human pregnancy","volume":"119","author":"Kruse","year":"2000","journal-title":"Clin Exp Immunol"},{"key":"2026032100073584400_bib31","doi-asserted-by":"crossref","first-page":"1736","DOI":"10.1086\/644784","article-title":"Immunopathogenesis and diagnosis of tuberculosis and tuberculosis-associated immune reconstitution inflammatory syndrome during early antiretroviral therapy","volume":"200","author":"Elliott","year":"2009","journal-title":"J Infect Dis"},{"key":"2026032100073584400_bib32","doi-asserted-by":"crossref","first-page":"F1","DOI":"10.1097\/01.aids.0000202648.18526.bf","article-title":"Explosion of tuberculin-specific Th1-responses induces immune restoration syndrome in tuberculosis and HIV co-infected patients","volume":"20","author":"Bourgarit","year":"2006","journal-title":"AIDS"},{"key":"2026032100073584400_bib33","doi-asserted-by":"crossref","first-page":"e96564","DOI":"10.1371\/journal.pone.0096564","article-title":"Discordance of tuberculin skin test and interferon gamma release assay in recently exposed household contacts of pulmonary TB cases in Brazil","volume":"9","author":"Ribeiro-Rodrigues","year":"2014","journal-title":"PLoS One"},{"key":"2026032100073584400_bib34","doi-asserted-by":"crossref","first-page":"1056","DOI":"10.5588\/ijtld.10.0650","article-title":"Predictors of discordant tuberculin skin test and QuantiFERON\u00ae-TB Gold In-Tube results in various high-risk groups","volume":"15","author":"Weinfurter","year":"2011","journal-title":"Int J Tuberc Lung Dis"},{"key":"2026032100073584400_bib35","first-page":"369","article-title":"QuantiFERON-TB Gold In-Tube test (QFT-GIT) for the screening of latent tuberculosis in recent immigrants to Italy","volume":"32","author":"Saracino","year":"2009","journal-title":"New Microbiol"},{"key":"2026032100073584400_bib36","doi-asserted-by":"crossref","first-page":"207","DOI":"10.1186\/1471-2334-9-207","article-title":"Performance of the tuberculin skin test and interferon-gamma release assay for detection of tuberculosis infection in immunocompromised patients in a BCG-vaccinated population","volume":"9","author":"Kim","year":"2009","journal-title":"BMC Infect Dis"},{"key":"2026032100073584400_bib37","doi-asserted-by":"crossref","first-page":"279","DOI":"10.1111\/1756-185X.12098","article-title":"Interferon-gamma release assays versus tuberculin skin testing in patients with rheumatoid arthritis","volume":"16","author":"Song","year":"2013","journal-title":"Int J Rheum Dis"},{"key":"2026032100073584400_bib38","doi-asserted-by":"crossref","first-page":"31","DOI":"10.1186\/1471-2172-10-31","article-title":"High-sensitive and rapid detection of Mycobacterium tuberculosis infection by IFN-gamma release assay among HIV-infected individuals in BCG-vaccinated area","volume":"10","author":"Jiang","year":"2009","journal-title":"BMC Immunol"},{"key":"2026032100073584400_bib39","doi-asserted-by":"crossref","first-page":"761","DOI":"10.1016\/S1473-3099(04)01206-X","article-title":"Interferon-gamma assays in the immunodiagnosis of tuberculosis: a systematic review","volume":"4","author":"Pai","year":"2004","journal-title":"Lancet Infect Dis"},{"key":"2026032100073584400_bib40","doi-asserted-by":"crossref","first-page":"539","DOI":"10.1007\/s15010-014-0588-2","article-title":"IGRA-positive patients and interferon-gamma\/interleukin-2 signatures: can the Fluorospot assay provide further information?","volume":"42","author":"Bittel","year":"2014","journal-title":"Infection"},{"key":"2026032100073584400_bib41","doi-asserted-by":"crossref","first-page":"e51338","DOI":"10.1371\/journal.pone.0051338","article-title":"Evaluation of the diagnostic potential of IP-10 and IL-2 as biomarkers for the diagnosis of active and latent tuberculosis in a BCG-vaccinated population","volume":"7","author":"Wang","year":"2012","journal-title":"PLoS One"},{"key":"2026032100073584400_bib42","doi-asserted-by":"crossref","first-page":"e46041","DOI":"10.1371\/journal.pone.0046041","article-title":"Potential role of M. tuberculosis specific IFN-\u03b3 and IL-2 ELISPOT assays in discriminating children with active or latent tuberculosis","volume":"7","author":"Chiappini","year":"2012","journal-title":"PLoS One"},{"key":"2026032100073584400_bib43","doi-asserted-by":"crossref","first-page":"347","DOI":"10.1111\/hiv.12120","article-title":"Impact of maternal hepatitis B virus coinfection on mother-to-child transmission of HIV","volume":"15","author":"Mave","year":"2014","journal-title":"HIV Med"},{"key":"2026032100073584400_bib44","doi-asserted-by":"crossref","first-page":"613","DOI":"10.1016\/0277-9536(92)90355-T","article-title":"Women\u2019s access to health care in developing countries","volume":"35","author":"Ojanuga","year":"1992","journal-title":"Soc Sci Med"},{"key":"2026032100073584400_bib45","volume-title":"Guidelines for intensified tuberculosis case finding and isoniazid preventive therapy for people living with HIV in resource constrained settings","author":"World Health Organization","year":"2011"}],"container-title":["American Journal of Respiratory and Critical Care Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/ajrccm\/article-pdf\/193\/12\/1421\/67256264\/ajrccm_193_12_1421.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ajrccm\/article-pdf\/193\/12\/1421\/67256264\/ajrccm_193_12_1421.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,21]],"date-time":"2026-03-21T04:07:48Z","timestamp":1774066068000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/ajrccm\/article\/193\/12\/1421\/8509004"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2016,6]]},"references-count":45,"journal-issue":{"issue":"12","published-online":{"date-parts":[[2016,6,15]]},"published-print":{"date-parts":[[2016,6,15]]}},"URL":"https:\/\/doi.org\/10.1164\/rccm.201508-1595oc","relation":{},"ISSN":["1073-449X","1535-4970"],"issn-type":[{"value":"1073-449X","type":"print"},{"value":"1535-4970","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2016,6]]},"published":{"date-parts":[[2016,6]]}}}