Latent tuberculosis infection in HIV-infected adults of Kinshasa, DR Congo

Abstract

Abstract Background The World Health Organization (WHO) End Tuberculosis Strategy calls for a 90% reduction in tuberculosis (TB) deaths and an 80% reduction in the incidence rate between 2015 and 2035. The 2018 WHO guidelines recognize the need for high-burden countries to implement outreach and treatment for the most vulnerable patients with latent TB infection (LTBI) in addition to treating patients with the active disease. The Democratic Republic of Congo (DR Congo) is among the countries bearing the highest burden of TB. However, additional data on LTBI is required for effective policy and strategy against the disease. Accordingly, the aim of this study is to estimate the prevalence of LTBI in HIV-infected adults in Kinshasa, DR Congo. Methods Over two hundred HIV-infected adult residents of Kinshasa were screened using both TUBERTEST®, which is a tuberculin skin test (TST), and QuantiFERON-TB Gold Plus® (QFT-Plus), which is an interferon gamma release assay. LTBI was screened using TST, QFT-Plus, and a combination of the two tests. The agreement between TST and QFT-Plus was calculated using Cohen’s Kappa coefficient. Results A total of 248 HIV-infected persons were enrolled in the study. Seventy-six patients (30.7% IC 95%: 25.2-36.7) had a positive TST result. Sixty-four (25.8% IC 95%: 20.7-31.6) had a positive QFT-Plus test result. The Kappa coefficient between TST and QFT-Plus was 0.225. Conclusions The prevalence of LTBI among HIV positive adults in Kinshasa was high considering either the positive TST or the positive QFT-Plus. However, the two tests had poor agreement.