Comparison of QuantiFERON-TB Gold In-Tube (QFT-GIT) and tuberculin skin test (TST) for diagnosis of latent tuberculosis in haemodialysis (HD) patients: a meta-analysis ofκestimates

Abstract

Diagnosis of latent tuberculosis infection (LTBI) is a concern in haemodialysis (HD) patients. Many studies have compared QuantiFERON-TB Gold In-Tube (QFT-GIT) and tuberculin skin test (TST) for detecting LTBI and reported the κ statistic of agreement between QFT-GIT and TST in HD patients. The present study aimed to systematically review this literature and conduct meta-analysis of individual studies that estimated the κ between QFT-GIT with TST among HD patients. All relevant published studies that were available as full-text were obtained by searching Medline (1950), Web of Sciences (1945), Scopus (1973) through May 2016. The κ was re-estimated from the individual studies and pooled using random effect meta-analysis. Subgroup analysis and meta-regression were applied to evaluate the effect of Bacillus Calmette-Guérin (BCG) vaccination, TST cut-off points, quality of studies, sample size and age on variation of κ estimate. Eight studies involving 901 HD patients were included in meta-analysis. The pooled κ estimate was 0·28 (I 2 = 18·4%, P = 0·239, 95% confidence intervals 0·22-0·34). The discordance of TST-/QFT-GIT+ was more than TST+/QFT-GIT-. History of BCG vaccination, TST cut-off points and age are related to variation of κ estimates. TST and QFT-GIT are not comparable in detecting LTBI in HD patients. The higher TST-/QFT-GIT+ ratio compared with TST+/QFT-GIT- ratio, may indicate the superiority of QFT-GIT over TST for detection LTBI in HD patients.

Performance Evaluation of a New Automated Chemiluminescent Immunoanalyzer-Based Interferon-Gamma Releasing Assay AdvanSure I3 in Comparison With the QuantiFERON-TB Gold In‑Tube Assay

“…The QFT-GIT assay is a whole-blood IGRA using M. tuberculosis -specific synthetic antigens, early secreted antigenic target 6 (ESAT-6), culture filtrate protein 10 (CFP-10), and TB 7.7, which stimulate T lymphocytes to release IFN-γ [6]. QFT-GIT assay results are more reliable than TST results, with a higher sensitivity and stronger correlation with exposure to M. tuberculosis [78]. Although QFT-GIT assay has several advantages over the TST, this assay uses microplate ELISA, which has some disadvantages in clinical laboratories such as labor-intense and time-consuming steps and the need for standard serial dilutions for every microplate.…”

Tuberculosis diagnosis: algorithm that May discriminate latent from active tuberculosis

“…This discrepancy could be attributed to difference in ethnicity or difference in the method used in subject enrolment. They used the tuberculin skin test in a population where BCG vaccine is systematically applied at birth [22, 23, 24]. We found an association between HLA-DRB1*12 and protection against TB infection-LTBI.…”

Diagnostic Value of Specific Immune Complexes in Detection of Active Tuberculosis Infection

“…Однако применение данных иммунологических методов не позволило проводить дифференциальную диагностику между латентной туберкулезной инфекцией и активным туберкулезом, так как тесты показывают положительный результат в обоих случаях [2,12,20].…”