中国感染控制杂志2025，Vol.24Issue(7)：953-959,7.DOI:10.12138/j.issn.1671-9638.20257250
结核特异性细胞因子IFN-γ与IL-2联合检测在HIV感染者结核病诊断中的价值及漏诊影响因素分析
Value of combined detection of tuberculosis specific cytokines IFN-γ and IL-2 in the diagnosis of tuberculosis in patients with human immunodefi-ciency virus infection and influencing factors for its underdiagnosis
摘要
Abstract
Objective To explore the value of dual factor combined detection using tuberculosis(TB)specific cy-tokines interferon-γ(IFN-γ)and interleukin-2(IL-2)in TB diagnosis in patients with human immunodeficiency vi-rus(HIV)infection,and the influencing factors for underdiagnosis.Methods HIV-infected patients admitted to and underwent TB-related examination in the Department of Infectious Diseases in Hezhou People's Hospital from July 2022 to September 2024 were collected.According to the clinical diagnosis criteria,patients were divided into the HIV infection with TB group(HIV/TB group)and the HIV infection without TB group(control group).Diag-nostic efficacy of dual factor combined detection was evaluated.HIV/TB group was further divided into a true-posi-tive group and a false-negative group based on the detection results.The independent influencing factors for underdia-gnosis was analyzed using multivariate logistic regression.Results A total of 306 patients were included in the analysis,with an average age of(55.69±14.02)years.There were 105 patients in the HIV/TB group and 201 in the control group.The sensitivity and specificity of dual factor combined detection for TB in all HIV-infected pa-tients were 72.4％(76/105)and 87.1％(175/201),respectively.There was a statistically significant difference in sensitivity(x2=9.488,P=0.009)and no statistically significant difference in specificity(x2=5.846,P=0.054)among the three CD4+T lymphocyte count gradients in the dual factor detection.Among them,patients with CD4+T cell count＜100 cells/μL had lower sensitivity(58.8％)in dual factor detection than patients with CD4+T cell count ≥200 cells/μL(88.9％)and 100-199 cells/μL(81.5％),differences were both statistically significant(both P＜0.05).In HIV/TB co-infected patients with CD4+T lymphocyte count ≥100 cells/μL,the general sensi-tivity and the specificity of dual factor combined detection were 85.2％(46/54)and 82.0％(91/111),respectively.Multivariate analysis showed that CD4+T lymphocyte count was an independent influencing factor for the underdia-gnosis in HIV/TB patients conducting dual factor combined detection(P＜0.05),while age,gender,pathogen re-sults,and the presence or absence of TB had no statistically significant impact on the results of dual factor combined detection(all P＞0.05).Conclusion Dual factor combined detection using tuberculosis-specific cytokines IFN-γand IL-2 has a high diagnostic value in the diagnosis of TB in HIV-infected patients,especially in those with CD4+T lymphocyte count ≥100/μL,which can provide auxiliary diagnostic value for the clinical diagnosis of HIV infection combined with TB.关键词
干扰素-γ/白细胞介素-2/艾滋病/结核病/人类免疫缺陷病毒/联合检测Key words
interferon-γ/interleukin-2/acquired immunodeficiency syndrome/tuberculosis/human immunodefi-ciency virus/combined detection分类
医药卫生引用本文复制引用
周莉萍,黄树庭,杨燕清,李繁,黄宛香..结核特异性细胞因子IFN-γ与IL-2联合检测在HIV感染者结核病诊断中的价值及漏诊影响因素分析[J].中国感染控制杂志,2025,24(7):953-959,7.基金项目
国家重点研发计划重点专项(2022YFC2305204-GX9) （2022YFC2305204-GX9）
