# Analysis of factors influencing latent tuberculosis infection screening using QuantiFERON-TB Gold In-Tube in people living with HIV/AIDS

## TL;DR

This study identifies age and immune markers like CD4/CD8 ratio as factors influencing latent TB infection risk in people with HIV/AIDS.

## Contribution

The study introduces a tailored screening approach for latent TB in PLWHA using CD4/CD8 ratio and QFT test results.

## Key findings

- Middle-aged PLWHA (45-<60 years) have higher LTBI prevalence.
- CD4/CD8 ratio ≥1 is strongly associated with increased LTBI risk.
- Nonlinear dose-response relationships exist between immune markers and LTBI risk.

## Abstract

To investigate the influencing factors associated with the risk of latent tuberculosis infection (LTBI) among people living with HIV/AIDS (PLWHA).

A cross-sectional study was conducted from July 2023 to July 2024, recruiting PLWHA from Wuxi City and Yangzhou City, Jiangsu Province, China. Data were collected through on-site questionnaire surveys and review of patient disease management records. QuantiFERON-TB Gold In-Tube (QFT) was used to detect LTBI. Multivariate logistic regression analysis was performed to identify factors associated with LTBI among PLWHA. Restricted cubic splines (RCS) models were employed to analyze the dose-response relationships between CD4+ cell count, CD8+ cell count, and CD4/CD8 ratio with LTBI risk.

A total of 1184 PLWHA were enrolled, with 8.4% having concomitant LTBI. Multivariate logistic regression revealed that age group 45-<60 years (OR = 2.158, 95% CI: 1.339-3.478, P = 0.002) and CD4/CD8 ratio ≥1 (OR = 3.562, 95% CI: 1.627-7.800, P = 0.001) were independent factors associated with LTBI. RCS model fitting results demonstrated a gradually increasing nonlinear dose-response relationship between continuous changes in CD4/CD8 ratio and LTBI. The dose-response relationship between CD4+ cell count and LTBI risk exhibited an “initial increase followed by a decrease trend. The dose-response relationship between CD8+ cell count and LTBI risk showed a gradual declining trend.

This study identified that middle-aged PLWHA (45-<60 years) might represent a subgroup with relatively higher LTBI prevalence, indicating that screening in this age group may hold greater potential value. Additionally, the CD4/CD8 ratio, in conjunction with QFT findings, could serve as a supplementary reference for LTBI risk assessment. These observations support a more tailored approach to LTBI screening in PLWHA, though their implementation should be validated in prospective studies.