- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT02119130
Quantiferon Gold Test for Detecting Tuberculosis (TB) Infection in HIV/AIDS Patients in South Africa
October 2, 2019 updated by: Johns Hopkins University
Quantiferon Gold Test for Detecting TB Infection in HIV/AIDS Patients in South Africa
The purpose of this study is to use a cluster randomized trial to compare the effectiveness of linking the Quantiferon-gold in-tube test (QGIT) with routine CD4 testing to the routine use of the tuberculin skin test (TST), the current standard of care for diagnosing latent tuberculosis infection (LTBI) in South Africa.
The investigators hypothesize that QGIT clinics will identify LTBI and initiate isoniazid preventive therapy (IPT) in a higher proportion of patients and in a significantly faster timeframe.
The cost-effectiveness of linking QGIT with routine CD4 compared to routine TST will also be evaluated, and the process of implementation of QGIT into the routine cluster of differentiation 4 (CD4) blood draw will be evaluated using a mixed method approach to identify steps that can be modified for future scale-up of the intervention.
Study Overview
Detailed Description
The investigators propose a cluster randomized trial in 16 HIV clinics in South Africa to compare time to determine LTBI status in patients in clinics using QGIT and TST and those with TST only.
The investigators will take advantage of the excellent HIV services provided in South Africa and link QGIT with CD4 blood collection and provide the first evidence of an operational comparison between QGIT and TST in HIV-infected patients in a country that accounts for one-third of the HIV-related TB in the world.
The QGIT study will contribute to the understanding of QGIT performance and implementation in HIV-infected individuals.
Careful evaluation of the implementation and operational aspects of the program will provide useful knowledge for future scale-up in this and other HIV clinic settings.
Study Type
Interventional
Enrollment (Actual)
3506
Phase
- Not Applicable
Contacts and Locations
This section provides the contact details for those conducting the study, and information on where this study is being conducted.
Study Locations
-
-
North West
-
Klerksdorp, North West, South Africa
- Tshepong Wellness Clinic
-
Klerksdorp, North West, South Africa
- Bothabelo CHC
-
Klerksdorp, North West, South Africa
- Grace Mokhomo
-
Klerksdorp, North West, South Africa
- Jouberton
-
Klerksdorp, North West, South Africa
- Marcus Zenzile
-
Klerksdorp, North West, South Africa
- NM Pretorious Gateway
-
Klerksdorp, North West, South Africa
- Orkney
-
Klerksdorp, North West, South Africa
- Park Street
-
Klerksdorp, North West, South Africa
- Stilfontein
-
Klerksdorp, North West, South Africa
- Tsholofelo
-
Potchefstroom, North West, South Africa
- Boiki Tihapi
-
Potchefstroom, North West, South Africa
- Potchefstroom Gateway
-
Potchefstroom, North West, South Africa
- Potchefstroom
-
Potchefstroom, North West, South Africa
- Steve Tshwete
-
-
Participation Criteria
Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.
Eligibility Criteria
Ages Eligible for Study
18 years and older (ADULT, OLDER_ADULT)
Accepts Healthy Volunteers
No
Genders Eligible for Study
All
Description
Inclusion Criteria:
- HIV-infected
- >= 18 years of age
- attending one of the 14 clinics during the duration of the study
- eligible to receive TST or IPT according to South Africa guidelines
Exclusion Criteria:
- diagnosed with active tuberculosis
- not eligible to receive TST or IPT according to South Africa guidelines
Study Plan
This section provides details of the study plan, including how the study is designed and what the study is measuring.
How is the study designed?
Design Details
- Primary Purpose: DIAGNOSTIC
- Allocation: RANDOMIZED
- Interventional Model: PARALLEL
- Masking: NONE
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
NO_INTERVENTION: TST only
Tuberculin skin test for all eligible patients, to be placed and read by clinic staff.
Thereafter, for 2 years, annual TST provided for patients with TST negative/unknown history.
IPT to be provided to patients with a positive TST for whom active TB has been ruled out.
|
|
EXPERIMENTAL: QGIT
QGIT for all eligible patients, to be done at routine CD4 blood draw.
Thereafter, for 2 years, annual QGIT at CD4 blood draw for patients with QGIT negative/unknown history.
IPT to be provided to patients with a positive QGIT for whom active TB has been ruled out.
|
Seven pairs of clinics will be included in this study.
One clinic in each pair will be selected by a computerized randomization program to be the standard of care arm (TST only) and the other will be in the QGIT arm.
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Time Frame |
---|---|
Impact of linking QGIT with CD4 blood collection and the current standard of care process of TST in HIV clinics in South Africa on operational metrics
Time Frame: Participants will be followed for the duration of the study, an expected average of 2 years
|
Participants will be followed for the duration of the study, an expected average of 2 years
|
Time to known latent TB infection status in clinics integrating QGIT with CD4 blood draw versus clinics with current standard of care (TST only)
Time Frame: Participants will be followed for the duration of the study, an expected average of 2 years
|
Participants will be followed for the duration of the study, an expected average of 2 years
|
Time to provision of IPT for eligible patients in QGIT versus TST-only clinics
Time Frame: Participants will be followed for the duration of the study, an expected average of 2 years
|
Participants will be followed for the duration of the study, an expected average of 2 years
|
Proportion of patients with known LTBI status in QGIT and TST-only clinics
Time Frame: Participants will be followed for the duration of the study, an expected average of 2 years
|
Participants will be followed for the duration of the study, an expected average of 2 years
|
Proportion of eligible patients receiving IPT between QGIT and TST-only clinics
Time Frame: Participants will be followed for the duration of the study, an expected average of 2 years
|
Participants will be followed for the duration of the study, an expected average of 2 years
|
Proportion of eligible patients receiving a second TST or QGIT following an initial negative test
Time Frame: Participants will be followed for the duration of the study, an expected average of 2 years
|
Participants will be followed for the duration of the study, an expected average of 2 years
|
Patient-, provider-, and clinic-level factors that impact outcomes within and between arms
Time Frame: Participants will be followed for the duration of the study, an expected average of 2 years
|
Participants will be followed for the duration of the study, an expected average of 2 years
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Cost effectiveness of implementing QGIT versus TST-only
Time Frame: 1 year
|
Costs and effectiveness (quality-adjusted life years) of LTBI screening and treatment with QGIT versus TST standard of care.
Looking at the impact on the HIV-associated TB epidemic in South Africa under each strategy and scenarios under which QGIT is cost-effective relative to TST, and vice versa.
|
1 year
|
Attitudinal and operational factors influencing the successful implementation of QGIT versus TST diagnostic practices from the perspective of key clinic personnel
Time Frame: up to 6 months
|
Knowledge, attitudes and practices of clinic personnel, along with consensus regarding key factors linked to successful screening
|
up to 6 months
|
Attitudinal and operational factors influencing the successful implementation of QGIT versus TST diagnostic practices from the perspective of patients
Time Frame: up to 6 months
|
Patients' understandings and experiences with TB screening approaches, along with consensus regarding key factors linked to successful screening
|
up to 6 months
|
Attitudinal and operational factors influencing the successful implementation of QGIT versus TST diagnostic practices from the perspective of clinic personnel
Time Frame: 1 year
|
Knowledge, attitudes and practices of clinic personnel, along with consensus regarding key factors linked to successful screening
|
1 year
|
Attitudinal and operational factors influencing the successful implementation of QGIT versus TST diagnostic practices from the perspective of patients
Time Frame: 1 year
|
Patients' understandings and experiences with TB screening approaches, along with consensus regarding key factors linked to successful screening
|
1 year
|
Attitudinal and operational factors influencing the successful implementation of QGIT versus TST diagnostic practices from the perspective of clinic personnel
Time Frame: 2 years
|
Knowledge, attitudes and practices of clinic personnel, along with consensus regarding key factors linked to successful screening
|
2 years
|
Attitudinal and operational factors influencing the successful implementation of QGIT versus TST diagnostic practices from the perspective of patients
Time Frame: 2 years
|
Patients' understandings and experiences with TB screening approaches, along with consensus regarding key factors linked to successful screening
|
2 years
|
Cost effectiveness of implementing QGIT versus TST-only
Time Frame: 2 years
|
Costs and effectiveness (quality-adjusted life years) of LTBI screening and treatment with QGIT versus TST standard of care.
Looking at the impact on the HIV-associated TB epidemic in South Africa under each strategy and scenarios under which QGIT is cost-effective relative to TST, and vice versa.
|
2 years
|
Collaborators and Investigators
This is where you will find people and organizations involved with this study.
Publications and helpful links
The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.
Study record dates
These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.
Study Major Dates
Study Start (ACTUAL)
November 1, 2014
Primary Completion (ACTUAL)
June 1, 2018
Study Completion (ACTUAL)
May 1, 2019
Study Registration Dates
First Submitted
April 10, 2014
First Submitted That Met QC Criteria
April 18, 2014
First Posted (ESTIMATE)
April 21, 2014
Study Record Updates
Last Update Posted (ACTUAL)
October 3, 2019
Last Update Submitted That Met QC Criteria
October 2, 2019
Last Verified
October 1, 2019
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
Other Study ID Numbers
- NA_00085133
- R01AI095041 (NIH)
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
Clinical Trials on HIV
-
University of Alabama at BirminghamMobile County Health Deparment; Alabama Department of Public HealthRecruitingHIV | HIV Testing | HIV Linkage to Care | HIV TreatmentUnited States
-
French National Agency for Research on AIDS and...Elizabeth Glaser Pediatric AIDS FoundationCompletedPartner HIV Testing | Couple HIV Counseling | Couple Communication | HIV IncidenceCameroon, Dominican Republic, Georgia, India
-
ANRS, Emerging Infectious DiseasesHopital Universitaire Robert-Debre; Institut de Recherche pour le Developpement and other collaboratorsUnknownHIV | HIV-uninfected Children | Children Exposed to HIVCameroon
-
University of MinnesotaWithdrawnHIV Infections | HIV/AIDS | Hiv | AIDS | Aids/Hiv Problem | AIDS and InfectionsUnited States
-
CDC FoundationGilead SciencesUnknownHIV Preexposure Prophylaxis | HIV ChemoprophylaxisUnited States
-
Africa Health Research InstituteLondon School of Hygiene and Tropical Medicine; University College, London; University... and other collaboratorsRecruiting
-
Massachusetts General HospitalNational Institute of Mental Health (NIMH); Fenway Community Health; Tuberculosis...CompletedHIV/STI Risk | HIV/STI IncidenceUnited States, India
-
Erasmus Medical CenterNot yet recruitingHIV Infections | Hiv | HIV-1-infection | HIV I InfectionNetherlands
-
University of WashingtonNational Institute of Mental Health (NIMH)RecruitingHIV Prevention | HIV Preexposure Prophylaxis | ImplementationKenya
-
University of Maryland, BaltimoreWithdrawnHiv | Kidney Transplant | HIV Reservoir | CCR5United States