艾滋病合并肺结核患者结核感染γ-干扰素释放试验结果假阴性的影响因素分析

Analysis of Influencing Factors of False Negative Results of Gamma-interferon Release Test for Tuberculosis Infection in AIDS Patients with Pulmonary Tuberculosis

目的:分析艾滋病合并肺结核患者结核感染γ-干扰素释放试验(TB-IGRA)结果假阴性的影响因素。方法:选取2021年1月—2023年3月孝感市第一人民医院感染科收治的艾滋病合并肺结核患者76例作为研究对象,均进行TB-IGRA,根据TB-IGRA结果分为真阳性组与假阴性组,比较两组临床资料,分析TB-IGRA结果假阴性的独立影响因素。结果:76例患者TB-IGRA结果阳性54例,TB-IGRA诊断艾滋病合并肺结核的灵敏度为71.1%(54/76),假阴性率为28.9%(22/76)。人类免疫缺陷病毒(HIV)病毒载量、年龄、CD4^(+)T细胞计数均为艾滋病合并肺结核患者TB-IGRA结果假阴性的独立影响因素(P<0.05)。结论:艾滋病合并肺结核患者TB-IGRA结果假阴性的影响因素包括HIV病毒载量、年龄、CD4^(+)T细胞计数,实际诊断时,需结合临床进行综合判断。

Objective:To analyze the influencing factors of false negative results of tuberculosis infection gamma-interferon release test(TB-IGRA)in AIDS patients with tuberculosis.Methods:Seventy-six patients with AIDS and tuberculosis admitted to the Department of Infection of Xiaogan First People's Hospital from January 2021 to March 2023 were selected as the study objects,and all of them underwent TB-IGRA.The results of TB-IGRA were divided into true positive group and false negative group.The clinical data of the two groups were compared to analyze the independent influencing factors of false negative results of TB-IGRA.Results:Among 76 patients,54 were positive for TB-IGRA,the sensitivity of TB-IGRA in the diagnosis of AIDS combined with tuberculosis was 71.1%(54/76),and the false negative rate was 28.9%(22/76);human immunodeficiency virus(HIV)viral load,age,CD4^(+)T cell count cell count were all independent influencing factors for false negative TB-IGRA results in AIDS patients with tuberculosis(P<0.05).Conclusion:Factors influencing false negative results of TB-IGRA in AIDS patients with tuberculosis include HIV viral load,age,CD4^(+)T cell count.In actual diagnosis,comprehensive judgment should be made in combination with clinical practice.