{"doi":"10.1093/cid/ciaa1135","title":"Optimal Testing Choice and Diagnostic Strategies for Latent Tuberculosis Infection Among US-Born People Living with Human Immunodeficiency Virus (HIV)","abstract":"BACKGROUND: Increased risk of progression from latent tuberculosis infection (LTBI) to tuberculosis (TB) disease among people living with human immunodeficiency virus (HIV; PLWH) prioritizes them for LTBI testing and treatment. Studies comparing the performance of interferon gamma release assays (IGRAs) and the tuberculin skin test (TST) among PLWH are lacking. METHODS: We used Bayesian latent class analysis to estimate the prevalence of LTBI and diagnostic characteristics of the TST, QuantiFERON Gold In-Tube (QFT), and T.SPOT-TB (TSPOT) among a prospective, multicenter cohort of US-born PLWH ≥5 years old with valid results for all 3 LTBI tests using standard US cutoffs (≥5 mm TST, ≥0.35 IU/mL QFT, ≥8 spots TSPOT). We also explored the performance of varying LTBI test cutoffs. RESULTS: Among 1510 PLWH (median CD4+ count 532 cells/mm3), estimated LTBI prevalence was 4.7%. TSPOT was significantly more specific (99.7%) and had a significantly higher positive predictive value (90.0%, PPV) than QFT (96.5% specificity, 50.7% PPV) and TST (96.8% specificity, 45.4% PPV). QFT was significantly more sensitive (72.2%) than TST (54.2%) and TSPOT (51.9%); negative predictive value of all tests was high (TST 97.7%, QFT 98.6%, TSPOT 97.6%). Even at the highest cutoffs evaluated (15 mm TST, ≥1.00 IU/mL QFT, ≥8 spots TSPOT), TST and QFT specificity was significantly lower than TSPOT. CONCLUSIONS: LTBI prevalence among this cohort of US-born PLWH was low compared to non-US born persons. TSPOT's higher PPV may make it preferable for testing US-born PLWH at low risk for TB exposure and with high CD4+ counts.","journal":"Clinical Infectious Diseases","year":2020,"id":82140,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":13,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9617,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2020-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":3905,"name":"Jason E. 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Garfein","orcid":"0000-0003-3663-7153","position":7,"is_corresponding":false},{"id":311221,"name":"Fernanda Maruri","orcid":"0000-0001-9533-8239","position":8,"is_corresponding":false},{"id":364038,"name":"Christine Ho","orcid":"0000-0002-2949-0184","position":9,"is_corresponding":false},{"id":425276,"name":"Jennifer Flood","orcid":null,"position":10,"is_corresponding":false},{"id":425277,"name":"Lisa Pascopella","orcid":null,"position":11,"is_corresponding":false},{"id":425278,"name":"Julie Higashi","orcid":null,"position":12,"is_corresponding":false},{"id":425279,"name":"Marisa Moore","orcid":null,"position":13,"is_corresponding":false},{"id":424152,"name":"Randall Reves","orcid":"0000-0002-5078-0653","position":17,"is_corresponding":false},{"id":424153,"name":"Amina Ahmed","orcid":"0000-0001-9494-742X","position":19,"is_corresponding":false},{"id":240257,"name":"Timothy R. Sterling","orcid":"0000-0002-4822-6979","position":20,"is_corresponding":false},{"id":311217,"name":"Henry M. Blumberg","orcid":"0000-0002-3110-2443","position":23,"is_corresponding":false},{"id":425280,"name":"Richard Brostrom","orcid":null,"position":26,"is_corresponding":false},{"id":425281,"name":"Renuka Khurana","orcid":null,"position":27,"is_corresponding":false},{"id":312967,"name":"Wendy Cronin","orcid":null,"position":28,"is_corresponding":false},{"id":292878,"name":"Susan E. Dorman","orcid":"0000-0001-6882-9470","position":29,"is_corresponding":false},{"id":424154,"name":"Masahiro Narita","orcid":"0000-0001-5825-5450","position":30,"is_corresponding":false},{"id":425282,"name":"Thaddeus L. Miller","orcid":null,"position":32,"is_corresponding":false},{"id":346880,"name":"April C. Pettit","orcid":"0000-0001-8832-0866","position":0,"is_corresponding":true}],"reference_count":23,"raw_metadata":null,"created_at":"2026-07-18T21:53:19.932222Z","pmid":"32761083","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}