Diagnostic performance of whole-blood interferon-γ assay and enzyme-linked immunospot assay for active tuberculosis,

Lai, Chih‐Cheng; Tan, Che-Kim; Lin, Sheng-Hsiang; Liao, Chun-Hsing; Huang, Yu-Tsung; Hsueh, Po-Ren

doi:10.1016/j.diagmicrobio.2011.05.013

Cited by 34 publications

(37 citation statements)

References 23 publications

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“…India (77%) 21 and South Africa (75%) 22 but lower than that reported in Taiwan (83%) 23 and Korea (92%). 24 A meta analysis of 73 studies published by Dai et al showed that the T-SPOT.TBassay had a sensitivity of 88% in studies done in China and a sensitivity of 90% in nonChinesestudies.…”

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confidence: 57%

T-SPOT. TB assay and tuberculin skin test for diagnosis and screening of tuberculosis: First report in a Sri lankan population

et al. 2015

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Objective: Guidelines encourage evaluation of an Interferon Gamma Release Assay (IGRA) in the local setting, particularly in low/middle income, Bacillus Calmette Guerin (BCG) vaccinated populations where the assays have shown variable utility. The T-SPOT.TB assay and the Tuberculin Skin Test (TST) were compared in diagnosis of active tuberculosis (TB) and in contact screening in an adult Sri Lankan population. Materials and Methods: A prospective study including confirmed TB cases (n=75), controls (n=-74) and close contacts of smear positive cases (n=27) was carried out at the regional Chest Clinic in Kandy district. Clinical history and investigation findings, including TST results were recorded and the T-SPOT. TB(Oxford Immunotec) performed. Results: The presence of diabetes and cavitation were significant predictors of T-SPOT.TB positivity, while TST had no significant clinical predictors. In the diagnosis of active TB, T-SPOT.TB sensitivity was 73.3% (95% CI, 58.6-84.6%) and a specificity was 72% (95% CI, 62.0-85.5%) while the TST sensitivity was 70.7% (95% CI, 54.2-83.3%) and specificity was 64.1% (95% CI, 49.7-76.5%). In contact investigation neither test showed an association with exposure level. Cost estimate was LKR 9400.00 per T-SPOT.TB test compared to LKR 200.00 per TST. A high (21%) indeterminate result rate was seen with the T-SPOT.TB assay. Conclusions: This study did not show any advantage in using T-SPOT.TB over TST in this setting.

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confidence: 57%

T-SPOT. TB assay and tuberculin skin test for diagnosis and screening of tuberculosis: First report in a Sri lankan population

et al. 2015

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“…The sensitivity, specificity, PPV, and NPV of the T-SPOT.TB test for the diagnosis of ATB are 84.95%, 85.12%, 82.94%, and 86.93%, respectively, according to recent research (4,8,12,15,16). When comparing the SFCs of the ATB and NATB groups, the median number of SFCs in the ATB group was significantly higher than that in the NATB group (P Ͻ 0.0001); in ATB patients, EPTB patients made up a significantly higher proportion than PTB patients (73.58% versus 26.42%; P Ͻ 0.05).…”

Section: Discussionmentioning

confidence: 89%

“…Currently, there are two commercially available IGRAs: QFT-G-IT and T-SPOT.TB. Studies show that the sensitivity of the T-SPOT.TB test is higher than that of QFT-G-IT and that the indeterminate rate of T-SPOT.TB is lower than that of QFT-G-IT (12)(13)(14).…”

Section: Discussionmentioning

confidence: 97%

Evaluation of the Characteristics of the Enzyme-Linked Immunospot Assay for Diagnosis of Active Tuberculosis in China

Wang¹,

Yu²,

Chen³

et al. 2015

Clin. Vaccine Immunol.

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bThe purpose of this study was to evaluate the characteristics of the T-SPOT.TB test for the diagnosis of active tuberculosis (ATB) and to distinguish ATB from other diseases using a receiver operating characteristic (ROC) curve. A total of 535 patients with suspected active tuberculosis were enrolled in the study and divided into ATB and nonactive tuberculosis (NATB) groups, as well as pulmonary tuberculosis (PTB) and extrapulmonary tuberculosis (EPTB) subgroups. The sensitivity, specificity, positive predictive value, negative predictive value, positive likelihood ratio, and negative likelihood ratio of the T-SPOT.TB test for the diagnosis of ATB were 84.95%, 85.12%, 82.94%, 86.93%, 5.71, and 0.18, respectively. The median number of spot-forming cells (SFCs) in the ATB group was higher than that in the NATB group (71 versus 1; P < 0.0001). The sensitivities in the PTB and EPTB subgroups were 92.31% and 81.77%. The areas under the curve (AUC) for the diagnosis of ATB using the T-SPOT.TB, early secreted antigenic target 6 (ESAT-6), and culture filtrate protein 10 (CFP-10) were 0.906, 0.884, and 0.877, respectively. A cutoff of 42.5 SFCs for ATB yielded a positive predictive value of 100%. Our study shows that the T-SPOT.TB test is useful for the diagnosis of ATB. Utilizing an ROC curve to select an appropriate cutoff made it possible to discriminate ATB from NATB.T uberculosis is a serious public health issue. Data from 202 countries and territories have shown that approximately 9 million people developed tuberculosis and 1.5 million people died from the disease in 2013 (1). China has the second heaviest burden of tuberculosis in the world, with 1 million new cases of active tuberculosis (ATB) each year and a reported Mycobacterium tuberculosis infection rate of 44.5% (2). The fifth national tuberculosis epidemiological survey in 2010 in China showed that the prevalence of active pulmonary tuberculosis (PTB) was 459/ 100,000 and the prevalence of smear-positive PTB was 66/100,000 in people over 15 years of age (3). At present, routine diagnostic methods for ATB in China include acid-fast bacillus smear, culture, pathology, erythrocyte sedimentation rate (ESR), and the tuberculin skin test (TST). However, as these methods have either low sensitivity or specificity or require a long time to provide a result, their clinical application has been limited.After M. tuberculosis infection, effector T cells targeting M. tuberculosis are generated in peripheral blood mononuclear cells (PBMCs) or body fluid mononuclear cells (MCs). These effector T cells secrete interferon gamma (IFN-␥) when stimulated by specific RD1 antigens, such as early secreted antigenic target 6 (ESAT-6) and culture filtrate protein 10 (CFP-10) (4-8), but these RD1 antigens are not present in Mycobacterium bovis bacillus Calmette-Guérin or in most environmental mycobacteria. The T-SPOT.TB test uses ESAT-6 and CFP-10 to stimulate effector T cells in the sample, which then secrete IFN-␥. The cytokine is then captured by specific antibodies in microtit...

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“…The QFT-GIT test was conducted on 1 ml of venous blood that was incubated at 37°C for 16-24 h. These procedures have been described elsewhere [27,28]. Calculations were performed using the QFT-GIT analysis software …”

Section: Laboratory Testsmentioning

confidence: 99%

“…Similarly, in the treatment of active TB, some studies have observed post-treatment mitigation of the IFN-γ response [18][19][20], while others have reported persistent or even stronger IFN-γ responses after anti-tuberculosis treatment [21][22][23][24]. Several studies on the performance of the QuantiFERON test have been conducted in Taiwan [25][26][27][28][29]; however, these studies were confined to 5 the diagnosis efficacy of LTBI and the comparison between the QuantiFERON test and TST. The aim of this study was to assess the potential use of the QFT-GIT test in the diagnosis, monitoring efficacy, and treatment of individuals with and without active TB and to evaluate the factors that influenced the performance of the test.…”

Section: Introductionmentioning

confidence: 99%

Use of the QuantiFERON-TB Gold In-Tube Test in the Diagnosis and Monitoring of Treatment Efficacy in Active Pulmonary Tuberculosis

Chang

Wang

Chen

2017

Preprint

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The value of QuantiFERON in the diagnosis of tuberculosis and in the monitoring of the response to anti-tuberculosis treatment is unclear. The aims of this study were to evaluate the accuracy of the QuantiFERON-TB Gold In-Tube (QFT-GIT) test in the diagnosis of tuberculosis and in the monitoring of the response to anti-tuberculosis treatment in patients with active pulmonary tuberculosis (PTB). Between January 2013 and December 2015, 128 cases with active PTB and 128 controls with no mycobacterial infection, matched by age (within 3 years) and by the week that they visited Tainan Chest Hospital, were enrolled in the study. Serial testing by QFT-GIT at baseline and after 2 and 6 months of treatment was performed. At these time points, a comparison of the performance of QFT-GIT with that of sputum culture status among study subjects was conducted. Compared to baseline, 116 (87.2%) cases showed a decreased response, whereas 17 (12.8%) showed persistent or stronger interferon-gamma (IFN-γ) responses at 2 months. Their IFN-γ responses declined significantly from baseline to 2 months (median, 6.32 vs. 4.12; P < 0.005). The sensitivity values of the QFT-GIT test for the detection of pulmonary tuberculosis at cut-off points of 0.35 IU/ml, 0.20 IU/ml, and 0.10 IU/ml were 74.4%, 78.2%, and 80.5%, respectively. The specificity values at cut-off points of 0.35 IU/ml, 0.20 IU/ml, and 0.10 IU/ml were 66.2%, 63.9%, and 57.1%, respectively. Our results support the QFT-GIT assay as a potential tool for diagnosing tuberculosis and for monitoring the efficacy of anti-tuberculosis treatment.

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Diagnostic performance of whole-blood interferon-γ assay and enzyme-linked immunospot assay for active tuberculosis,

Cited by 34 publications

References 23 publications

T-SPOT. TB assay and tuberculin skin test for diagnosis and screening of tuberculosis: First report in a Sri lankan population

T-SPOT. TB assay and tuberculin skin test for diagnosis and screening of tuberculosis: First report in a Sri lankan population

Evaluation of the Characteristics of the Enzyme-Linked Immunospot Assay for Diagnosis of Active Tuberculosis in China

Use of the QuantiFERON-TB Gold In-Tube Test in the Diagnosis and Monitoring of Treatment Efficacy in Active Pulmonary Tuberculosis

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