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A new more effective tuberculosis screening test for HIV victims
Date:3/5/2008

hed of an investigation conducted in Senegal, coordinated by IRD in conjunction with other scientific institutions,1 yield important information on the comparative efficiency of the immunological method and the standard TST. The research team set up two cohorts of patients living in the Dakar area: the first one made up of HIV-infected individuals but with no detected TB; the second consisting of TB patients and people from the treatment centre who had been in contact with them during a given period.

For the first cohort, 285 adults newly infected by HIV and showing no clinical or radiological sign of TB were selected at the Fann National University Hospital Centre (Dakar) between 2003 and 2004. An ELISPOT test and a TST were performed for each patient at the beginning of the study. The TST indicated that 21% (53/247) of them had a TB infection at the moment of the test. However, this proportion reached 51% (125/247) with the ELISPOT test. It appears therefore that the latter is more sensitive than the TST whatever the stage of development of the disease. Nevertheless the ability to respond to the ELISPOT test decreases with the decrease in CD4 lymphocyte count, which appears to indicate the limits of this type of test in severely immunosuppressed individuals, as advanced-stage HIV infected patients can be.

In parallel, a cohort of 243 TB patients was followed up for 2 years. The objective this time was to determine the ability of the ELISPOT test to predict, among people living in contact with these individuals, those who run the greatest risk of developing the disease. Between January 2004 and March 2005, 3072 contacts were identified for the whole set of TB patients. Preliminary results showed the sensitivity of the two tests to be comparable with this cohort, although ELISPOT is doted with a better specificity since it is not influenced by recent BCG vaccination.

The data gathered from the studies must now be analysed in greater detail i
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Contact: Press Office
fichesactu@paris.ird.fr
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Institut de Recherche Pour le Dveloppement
Source:Eurekalert

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