Relevance and acceptability of using the Quantiferon gold test (QGIT) to screen CD4 blood draws for latent TB infection among PLHIV in South Africa: formative qualitative research findings from the TEKO trial
Relevance and acceptability of using the Quantiferon gold test (QGIT) to screen CD4 blood draws for latent TB infection among PLHIV in South Africa: formative qualitative research findings from the TEKO trial
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DOI：
10.1186/s12913-018-3088-8
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发表时间：
2018-04-16
影响因子：
2.8
通讯作者：
Golub, Jonathan E.
中科院分区：
文献类型：
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作者：
Kerrigan, Deanna;Tudor, Carrie;Golub, Jonathan E.
背景：尽管有有效的预防治疗，但结核病 (TB) 仍是艾滋病毒感染者 (PLHIV) 死亡的主要原因。 TEKO 试验正在评估南非 PLHIV 中使用血液检测、Quantiferon-TB Gold In-Tube Test (QGIT) 筛查潜伏性结核病的效果，与结核菌素筛查试验 (TST) 相比。方法：对参与 TEKO 试验的 PLHIV 和临床提供者进行了 56 次定性访谈。我们探索了结核病筛查、诊断和治疗指南和流程，以及使用 QGIT 在 CD4 抽血时筛查潜伏结核病感染。进行了主题内容分析。结果：由于缺乏人员且现行国家艾滋病毒感染者结核病指南不明确，结核病筛查程序存在相当大的差异。很少有诊所按照国家指南开始使用 TST，许多患者从未听说过异烟肼预防性治疗 (IPT)。几乎所有参与者都支持使用常规抽血进行 CD4 计数筛查潜伏性结核病的想法。结论：研究结果表明，考虑到在负担过重的公立诊所中确保系统性潜伏性结核病筛查所面临的挑战，使用从 PLHIV 中抽血进行 CD4 计数的 QGIT 筛查潜伏性结核病是一种可以接受的增加潜伏性结核病检测的方法。
Background: Tuberculosis (TB) is the leading cause of mortality among people living with HIV (PLHIV), despite the availability of effective preventive therapy. The TEKO trial is assessing the impact of using a blood test, Quantiferon-TB Gold In-Tube Test (QGIT), to screen for latent TB compared to the Tuberculin Screening Test (TST) among PLHIV in South Africa.Methods: Fifty-six qualitative interviews were conducted with PLHIV and clinical providers participating in the TEKO trial. We explored TB screening, diagnosis, and treatment guidelines and processes and the use of the QGIT to screen for latent TB infection at the time of CD4 blood draw. Thematic content analysis was conducted.Results: Considerable variability in TB screening procedures was documented due to lack of personnel and clarity regarding current national TB guidelines for PLHIV. Few clinics had started using the TST per national guidelines and many patients had never heard of isoniazid preventive therapy (IPT). Nearly all participants supported the idea of latent TB screening using routine blood drawn for CD4 counts.Conclusions: Findings indicate that screening for latent TB infection using QGIT from blood drawn for CD4 counts among PLHIV is an acceptable approach to increase latent TB detection given the challenges associated with ensuring systematic latent TB screening in overburdened public clinics.