{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,9]],"date-time":"2026-07-09T03:31:04Z","timestamp":1783567864941,"version":"3.55.0"},"reference-count":24,"publisher":"European Respiratory Society (ERS)","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Eur Respir J"],"accepted":{"date-parts":[[2010,1,6]]},"published-print":{"date-parts":[[2010,9]]},"abstract":"<jats:p>The sensitivity of the tuberculin skin test is impaired in HIV-1-infected persons. Enzyme-linked immunospot-based detection of immune sensitisation may be less affected. Furthermore, the quantitative response can be related to the CD4 count, potentially improving specificity for active disease.<\/jats:p><jats:p>The T-SPOT.<jats:italic>TB<\/jats:italic>assay was performed on HIV-1-infected participants, 85 with active tuberculosis (TB) and 81 healthy patients (non-TB). The ratio of the sum of the 6-kDa early secretory antigenic target and culture filtrate protein 10 response to the CD4 count (spot-forming cell (SFC)\/CD4) was calculated.<\/jats:p><jats:p>Using the manufacturer's guidelines, active TB was diagnosed with 76% sensitivity and 53% specificity. Using an SFC\/CD4 ratio of 0.12, sensitivity (80%) and specificity (62%) improved. The quantitative T-cell response increased with increasing smear-positivity in the active TB group (p = 0.0008). In the non-TB group, the proportion of persons scored positive by T-SPOT.<jats:italic>TB<\/jats:italic>assay was lower in the group with a CD4 count of &lt;200 cells\u00b7mm<jats:sup>\u22123<\/jats:sup>(p = 0.029).<\/jats:p><jats:p>The ratio of the summed T-cell response to CD4 count improved the diagnostic accuracy of the T-SPOT.<jats:italic>TB<\/jats:italic>assay in HIV-1-infected persons, and a ratio of SFC\/CD4 of &gt;0.12 should prompt investigation for active disease. A strong association between the degree of sputum positivity and T-SPOT.<jats:italic>TB<\/jats:italic>score was found. The sensitivity of the T-SPOT.<jats:italic>TB<\/jats:italic>assay in active disease may be less impaired by advanced immunosuppression.<\/jats:p>","DOI":"10.1183\/09031936.00171509","type":"journal-article","created":{"date-parts":[[2010,1,15]],"date-time":"2010-01-15T01:33:26Z","timestamp":1263519206000},"page":"594-600","source":"Crossref","is-referenced-by-count":25,"title":["Enhanced diagnosis of HIV-1-associated tuberculosis by relating T-SPOT.<i>TB<\/i>and CD4 counts"],"prefix":"10.1183","volume":"36","author":[{"given":"T.","family":"Oni","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J.","family":"Patel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"H.P.","family":"Gideon","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R.","family":"Seldon","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"K.","family":"Wood","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Y.","family":"Hlombe","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"K.A.","family":"Wilkinson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M.X.","family":"Rangaka","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M.","family":"Mendelson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R.J.","family":"Wilkinson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"81","published-online":{"date-parts":[[2010,1,14]]},"reference":[{"key":"2024102020111958000_36.3.594.1","unstructured":"World Health Organization. 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