Nabil Salim Ambar, Aryati Aryati, Tutik Kusmiati, Erwin Astha Triyono


Introduction. HIV is a virus that can cause AIDS, which affects the immune system and weakens the body function in fighting disease. The primary cells that HIV attacks are CD4+ T lymphocytes. Opportunistic Infections (OIs) are the biggest risk factors of death in HIV patients and occur in CD4+ T cells <200 cells/μL lymphocytes. TB is a disease with a high mortality rate in the world where Indonesia is a TB endemic country with the highest morbidity rates of TB in the world. The most common OI in people with HIV is TB. The number of limitations on Tuberculin Skin Test (TST) is large, thus in vitro T cells test with (Interferon Gamma Release Assay) IGRA is used in diagnosing latent TB. The aim of this study was to determine the correlation between IGRA ELISPOT method and CD4+ T lymphocyte cell count in HIV positive patients.

Method. This was an observational analytical study with cross sectional design. The number of samples was 56 HIV positive patients who were treated at the UPIPI Clinic of the Dr Soetomo Surabaya Hospital. The examination of CD4+ T lymphocyte count was perfomed with FACSCalibur and IGRA was examined with T-SPOT.TB. The results were analyzed using Spearman correlation test.

Results. CD4 + lymphocyte cell counts based on WHO groupings were as follows: > 500 cells / μL (33.92%), 200-349 cells / μL (25%), 350-499 cells / μL (25%) and <200 cells / μL (16 , 07%). IGRA examination results showed 35.18% positive and 64.81% negative. The grouping of CD4+ T lymphocyte cell counts based on IGRA test results was 27.77% with positive IGRA and 48.14% with negative IGRA. Spearman correlation test between CD4+ T cell lymphocytes with IGRA in HIV positive patients showed r = 0,036 (p = 0,794).

Conclusion. There was no correlation between interferon gamma release assay of ELISPOT method and CD4+ T lymphocyte cell count in HIV positive patients.


HIV, CD4+ T lymphocyte cell, latent TB, IGRA.


Kementrian Kesehatan RI. 2014. Situasi dan Analisis HIV AIDS. Infodatin. Pusat data dan informasi kementrian kesehatan RI. Accessed August 1 2017. Available at:

Widiyanti M, Fitriana E, Iriani E et al. 2016. ‘Karakteristik Pasien Koinfeksi TB-HIV di Rumah Sakit Mirna Masyarakat Mimika Papua’. SEL Jurnal Penelitian Kesehatan Vol. 3 No.2. Badan Penelitian dan Pengembangan Kesehatan. Kementrian Kesehatan Republik Indonesia. Accessed August 9 2017 Available at:

Parrela R, Esposito V, Onofrio M, Parrella G, Viglietti R, et al. 2015. ‘Interferon Gamma Release Assays and Tuberculin Skin Test Performance in Different Settings of HIV Immunodeficiency’. In vivo journal 29: 137-140. Accessed July 18 2017 Available at:

World Health Organization. 2015. ‘Global Strategy and Targets for Tuberculosis Prevention, Care and Control After 2015’. Accessed July 28 2017 Available at:

European Centre for Disease Prevention and Control. 2011. ‘ECDC Guidance - Use of Interferon-Gamma Release Assays in Support of TB Diagnosis’. Accessed December 15 2016. Available at:

World Health organization. 2016. ‘Global Health Observatory (GHO) data HIV/AIDS’. Accessed September 19 2017 Available at:

Hounton SH, Carabin Helene, Henderson J Neil. 2005. Towards an understanding of barriers to condom use in rural Benin using the Health Belief Model: A cross sectional survey. BMC Public Health 2005 5:8. Accessed August 2 2017 Available at:

Nwokoji UA and Ajuwon AJ. 2004. Research article ‘Open Access Knowledge of AIDS and HIV risk-related sexual behavior among Nigerian naval personnel’. BMC Public Health 2004, 4:24. Accessed September 19 2017 Available at:

Depkes RI dan Komisi Penanggulangan AIDS. 2006. Laporan Nasional Kegiatan Estimasi Populasi Dewasa Rawan Terinfeksi HIV Tahun 2006. Jakarta: KPAN.2006.

Heri W, Antono S, Zahroh S. 2008. ‘Faktor-Faktor Yang Berhubungan Dengan Penggunaan Jarum Suntik Bergantian Diantara Pengguna Napza Suntik Di Kota Semarang’. Jurnal Promosi Kesehatan Indonesia Vol. 3 / No. 2 / Agustus 2008. Accessed 1 August 2017 Available at:

World Health Organization. 2009. ‘WHO Case Definitions Of HIV For Surveillance And Revised Clinical Staging And Immunological Classification Of HIV-Related Disease In Adults And Children’. Accessed September 19 2017 Available at:

Mrudula ND, U Phute S, RK Khadse, Patil M,1 and D Kulkarni S. 2012. ‘Statistical Analysis and Evaluation of CD4 Count after 6 Months on ART’. Indian J Community Med. 2012 Oct-Dec; 37(4): 266–267. doi: 10.4103/0970-0218.103480 Accessed September 19 2017 Available at:

Mocroft A, Phillips AN, Gatell J, Ledergerber B, Fisher M, et al. 2007. Normalisation of CD4 counts in patients with HIV-1 infection and maximum virological suppression who are taking combination antiretroviral therapy: an observational cohort study. The LANCET Journal. Volume 370, No. 9585, p407–413, 4 August 2007. Accessed September 9 2017 Available at:

Mandal, B.K. 2008. Penyakit Infeksi. Lecture Notes. 6th ed. Jakarta: Erlangga.

WHO. 2006. Antiretroviral therapy for HIV infection in adults and adolescent. In recommendations for a public health.

Oni T, Patel J, Gideon HP, Seldon R, Wood K, et al. 2010. Enhanced diagnosis of HIV-1-associated tuberculosis by relating T-SPOT.TB and CD4 counts. Eur Respir J 2010; 36: 594–600 DOI: 10.1183/09031936.00171509. Accessed July 18 2017. Available at:

Ramos JM, Robledano C, Masiá M, Belda S, Padilla S, et al. 2012. Contribution of interferon gamma release assays testing to the diagnosis of latent tuberculosis infection in HIV- infected patients: A comparison of QuantiFERON-TB Gold in Tube, T-SPOT.TB and tuberculin skin test.BMC infectious diseases 2012, 12:169 Available at:

Rangaka MX, Diwakar L, Seldon R, Cutsem GV, Meintjes GA, et al. 2007. Clinical, Immunological, and Epidemological importance of antitubrculosis T cell responses in HIV-infected Africans. Clin Infect Dis; 44 1639-1646. Available at :

Rangaka MX, Wilkinson KA, Seldon R, Cutsem GV, Meintjes GA, et al. 2007. Effect of HIV-1 infection on T-cell-based and skin test detection of tuberculosis infection. Am J respir Crit Care Med. 175: 514-520. Available at :

Cai R, Chen J, Guan L , Sun M , Sun Y , et al. 2014. Relationship between T-SPOT.TB responses and numbers of circulating CD4+ T-cells in HIV infected patients with active tuberculosis. BioScience Trends. 2014; 8(3):163-168. DOI: 10.5582/bst.2014.01032. Accessed July 28 2017. Available at:

Sinaga Fransisca T.Y. 2017. Validitas dan reabilitas pemeriksaan TST dan T-SPOT TB dalam mendeteksi infeksi TB laten pada penderita infeksi HIV. Tesis pascasarjana universitas sebelas maret. Available at :

Elzi L. 2011. Improved sensitivity of an interferon-gamma release assay (T-SPOT.TB™) in combination with tuberculin skin test for the diagnosis of latent tuberculosis in the presence of HIV co-Infection. BMC Infect Dis. 2011; 11: 319.

Published online 2011 Nov 15. doi: 10.1186/1471-2334-11-319 Accessed December 20 2016. Available at:

Salvaggio A. 1996. CD4 count in HIV infection is positively correlated to interferon-γ and negatively correlated to intcrlcukin-10 in vitro production. AIDS Journal: April 1996 - Volume 10 - Issue 4 - ppg 449-450. Accessed August 18 2017 Available at:

Sultan B, Benn P, Mahungu T, Young M, Mercey D, et al. 2013. Comparison of two interferon-gamma release assays (QuantiFERON-TB Gold In-Tube and T-SPOT.TB) in testing for latent tuberculosis infection among HIV-infected adults. International Journal of STD & AIDS 24(10) 775–779. Accessed July 18 2017 Downloaded at:

Kaufmann GR, Furrer H, Ledergerber B, Perrin L, Opravil M, et al. 2005. Characteristics, determinants, and clinical relevance of CD4 T cell recovery to <500 cells/microL in HIV type 1-infected individuals receiving potent antiretroviral therapy. Clin Infect Dis. 2005 Aug 1;41 (3): 361-72. Available at :

Boris J., Danielle P, Musie G., Carmen C., Marcus A., at al. 2012. Factors predicting discordant virological and immunological responses to antiretoviral therapy in HIV-1 clade C infected Zulu/Xhosa in south Africa. PLOSO ONE. Available at :

Handayani F dan Fatwa STD. 2017. Faktor yang mempengaruhi kualitas hidup orang dengan HIV/ AIDS (ODHA) di kota Kupang. Journal of Community Medicine and Public Health. Berita Kedokteran Masyarakat Vol. 33 No. 11

Chen J, Sun J, Zhang R, Liu L, Zheng Y, et al. 2011. T-SPOT.TB in the diagnosis of active tuberculosis among HIV-infected patients with advanced immunodeficiency. AIDS Res Hum Retroviruses Mar;27 (3); 289-94. Doi:10.1089/aid.2010.0062. available at :

Aabye MG, Ravn P, God GP, Jeremiah K, Mugomela A, et al. 2009. The impact of HIV infection and CD4 cell count on the performance of an interferon gamma release assay in patients with pulmonary tuberculosis. PLoS One Journal. 2009;4(1):e4220. doi: 10.1371/journal.pone.0004220. Epub 2009 Jan 19. Accessed August 17 2017. Available at:



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