Factors influencing discordant results of the QuantiFERON-TB Gold In-tube test in patients with active TB

Jeon, You La; Nam, You-sun; You, Eunkyoung; Yang, John Jeongseok; Kim, Min Jin; Cho, Sun Young; Park, Tae Sung; Lee, Hee Joo

doi:10.1016/j.jinf.2013.06.005

Cited by 23 publications

(38 citation statements)

References 17 publications

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“…Old age remains a known risk factor for false-negative IGRA results and the current study supports these findings [12–14, 17, 18, 21]. The IFN-γ response in the QFT-GIT was decreased in elderly patients (≥80 years) with culture-confirmed TB, and the median age of patients with negative results was also higher [17, 18].…”

Section: Discussionsupporting

confidence: 79%

“…The IFN-γ response in the QFT-GIT was decreased in elderly patients (≥80 years) with culture-confirmed TB, and the median age of patients with negative results was also higher [17, 18]. Age was also an independent risk factor for negative results being observed in smear-positive pulmonary TB as well as for indeterminate or negative results in culture-confirmed TB [13, 14]. We observed that advanced age (≥65 years of age) is an independent predictive factor for negative QFT-GIT results in patients with active TB, which was consistent with the findings of previous studies.…”

Section: Discussionmentioning

confidence: 99%

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Factors that Predict Negative Results of QuantiFERON-TB Gold In-Tube Test in Patients with Culture-Confirmed Tuberculosis: A Multicenter Retrospective Cohort Study

et al. 2015

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BackgroundInterferon-γ release assays such as the QuantiFERON-TB Gold In-Tube Test (QFT-GIT) are designed to detect Mycobacterium tuberculosis infections, whether latent or manifesting as disease. However, a substantial number of persons with culture-confirmed tuberculosis (TB) have negative QFT-GITs. Information on host factors contributing to false-negative and indeterminate results are limited.MethodsA multicenter retrospective cohort study was performed with 1,264 culture-confirmed TB patients older than 18 years who were subjected to the QFT-GIT at one of the six hospitals between May 2007 and February 2014. Patients with human immunodeficiency virus infection were excluded. Clinical and laboratory data were collected in South Korea.ResultsOf all patients, 87.6% (1,107/1,264) were diagnosed with pulmonary TB and 12.4% (157/1,264) with extrapulmonary TB. The rate of negative results was 14.4% (182/1,264). The following factors were highly correlated with false-negative results in the QFT-GIT: advanced age (age ≥ 65 years, odds ratio [OR] 1.57, 95% confidence interval [CI] 1.03–2.39), bilateral disease as determined by chest radiography (OR 1.75, 95% CI 1.13–2.72), malignancy (OR 2.42, 95% CI 1.30–4.49), and lymphocytopenia (total lymphocyte count < 1.0 × 109/L, OR 1.86, 95% CI 1.21–2.87).ConclusionsConsequently, QFT-GIT results need to be interpreted with caution in patients with these host risk factors such as the elderly, bilateral disease on chest radiography, or malignancy, or lymphocytopenia.

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Section: Discussionsupporting

confidence: 79%

Section: Discussionmentioning

confidence: 99%

Factors that Predict Negative Results of QuantiFERON-TB Gold In-Tube Test in Patients with Culture-Confirmed Tuberculosis: A Multicenter Retrospective Cohort Study

et al. 2015

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“…23 In our study, the T-SPOT.TB test showed the highest concordance rate in pulmonary TB patients in the 21e30 age group (97%), in accordance with previous reports indicating that the QFT-G and QFT-IT tests have higher sensitivity in the 20e29 age group among Japanese and Korean TB patients (92%, 93% and 89.5%). 22,35,37 Taken together, these results confirm the detrimental impact of increased age on the sensitivity of the T-SPOT.TB test. It has previously been suggested that lymphocytopenia and decreased function of T lymphocytes cells may be the two causative reasons of decreased sensitivity in IGRA tests.…”

Section: Relationship Between Ifn-g Production and The Risk Factors Isupporting

confidence: 73%

“…Liao et al did not analyze the IFN-g production and the concordance rate of T-SPOT.TB by age, possibly because of the lower number of false-negative T-SPOT.TB results (only 10 patients) in their study. Increased age has also been validated as a risk factor for false-negative results in the OFT-G and QFT-IT tests in patients with active TB, 22,35,36 and in smear-positive pulmonary TB patients. 23 In our study, the T-SPOT.TB test showed the highest concordance rate in pulmonary TB patients in the 21e30 age group (97%), in accordance with previous reports indicating that the QFT-G and QFT-IT tests have higher sensitivity in the 20e29 age group among Japanese and Korean TB patients (92%, 93% and 89.5%).…”

Section: Relationship Between Ifn-g Production and The Risk Factors Imentioning

confidence: 99%

Risk factors for false-negative T-SPOT.TB assay results in patients with pulmonary and extra-pulmonary TB

Pan

Jia

Liu

et al. 2015

Journal of Infection

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“…We finally included 17 studies in this systematic review: 14 6,7,13-24 and 3 studies 8,25,26 were retrospective and prospective observational studies, respectively. These published studies, 4 from low-incidence countries: United States of America (n = 2) 6,22 , Denmark (n = 1) 13 and the EU (n = 1) 14 ; 11 from middle-incidence countries: South Korea (n = 6) 14, [16][17][18]20,26 and China (n = 4) 8,13,15,21 and Japan (n = 1) 7 ; and 3 from high-incidence countries: Viet Nam (n = 1) 25 , Tanzania (n = 1) 13 and Zambia (n = 1) 23 . The results from Denmark and Tanzania were reported collectively in one study 13 .…”

Section: Resultsmentioning

confidence: 99%

Factors associated with false negative interferon-γ release assay results in patients with tuberculosis: A systematic review with meta-analysis

Yamasue

Komiya

Usagawa

et al. 2020

Sci Rep

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Which factors are related to false negative results of the interferon-γ release assay (iGRA) is unclear. This systematic review described the risk factors associated with false negative IGRA results. Two authors independently identified studies designed to evaluate risk factors for false negative IGRA results from PubMed, the Cochrane Register of Control Trial database, and EMBASE, accessed on October 22, 2018. Meta-analyses were conducted with random-effect models, and heterogeneity was calculated with the I 2 method. Of 1,377 titles and abstracts screened, 47 full texts were selected for review, and we finally included 17 studies in this systematic review. The most commonly studied risk factor (14 studies) was advanced age, followed by low peripheral lymphocyte counts (7 studies), and these factors were associated with false negative results even with different tuberculosis incidences (pooled odds ratio 2.06; 95% CI, 1.68-2.52 in advanced age and 2.68; 95% CI, 2.00-3.61 in low peripheral lymphocyte counts). Advanced age and low peripheral lymphocyte counts may be common risk factors for false negative IGRA results, suggesting that people with these factors need to be carefully followed, even if they have negative iGRA results.

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Factors influencing discordant results of the QuantiFERON-TB Gold In-tube test in patients with active TB

Cited by 23 publications

References 17 publications

Factors that Predict Negative Results of QuantiFERON-TB Gold In-Tube Test in Patients with Culture-Confirmed Tuberculosis: A Multicenter Retrospective Cohort Study

Factors that Predict Negative Results of QuantiFERON-TB Gold In-Tube Test in Patients with Culture-Confirmed Tuberculosis: A Multicenter Retrospective Cohort Study

Risk factors for false-negative T-SPOT.TB assay results in patients with pulmonary and extra-pulmonary TB

Factors associated with false negative interferon-γ release assay results in patients with tuberculosis: A systematic review with meta-analysis

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