Is the Sensitivity of the QuantiFERON-TB Gold In-Tube Test Lower Than That of T-SPOT.TB in Patients With Miliary Tuberculosis?

Hong, Sun In; Lee, Yu-Mi; Park, Ki Ho; Kim, Sung-Han

doi:10.1093/cid/ciu248

Cited by 8 publications

(10 citation statements)

References 6 publications

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“…Furthermore, The QFT-GIT is based on the ELISA method, while T-SPOT.TB assay is based on the ELISPOT method. The sensitivity of QFT-GIT is strongly affected by immunosuppressed status with only a slight effect of antigenic load, whereas the sensitivity of T-SPOT.TB is strongly affected by the antigenic load with only a slight effect of immunosuppressed status 11 , 26 . The present study enrolledspecified patients with active TB with nonimmunosuppressed conditions, seems to reduce the differences between the blood tests might provide slightly different results in generalization.…”

Section: Discussionmentioning

confidence: 97%

“…Furthermore, most indeterminate results of both tests were caused by insufficient response to the positive control antigens. It can be speculated that the patients with weak immune system response to the positive control yield a response that is insufficiently strong to be measured 11 , 13 . The main differences between the QFT-GIT and T-SPOT.TB lie in the specimens used (whole blood versus mononuclear cells).…”

Section: Discussionmentioning

confidence: 99%

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Prospective Comparison of QFT-GIT and T-SPOT.TB Assays for Diagnosis of Active Tuberculosis

Xie

Zhang

et al. 2018

Sci Rep

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T-SPOT.TB and QuantiFERON-TB Gold In-Tube (QFT-GIT) tests, as two commercial blood assays for diagnosing active tuberculosis (ATB), are not yet fully validated. Especially, there are no reports on comparing the efficacy between the two tests in the same population in China. A multicenter, prospective comparison study was undertaken at four hospitals specializing in pulmonary diseases. A total of 746 suspected pulmonary TB were enrolled and categorized, including 185 confirmed TB, 298 probable TB and 263 non-TB. Of 32 patients with indeterminate test results (ITRs), age and underlying disease were associated with the rate of ITRs. Furthermore, the rate of ITRs determined by T-SPOT.TB was lower than QFT-GIT (0.4% vs. 4.3%, P < 0.01). When excluding ITRs, the sensitivities of T-SPOT.TB and QFT-GIT were 85.2% and 84.8%, and specificities of 63.4% and 60.5%, respectively in the diagnosis of ATB. The two assays have an overall agreement of 92.3%, but exhibited a poor linear correlation (r2 = 0.086) between the levels of interferon-γ release detected by the different assays. Although having some heterogeneity in detecting interferon-γ release, both the QFT-GIT and T-SPOT.TB demonstrated high concordance in diagnosing ATB. However, neither of them showed suitability in the definitive diagnosis of the disease.

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Section: Discussionmentioning

confidence: 97%

Section: Discussionmentioning

confidence: 99%

Prospective Comparison of QFT-GIT and T-SPOT.TB Assays for Diagnosis of Active Tuberculosis

Xie

Zhang

et al. 2018

Sci Rep

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“…Numerous studies using Quantiferon-CMV have been reported in SOT recipients [28][29][30][32][33][34][35][36]. However, the ELISA-based assay is less sensitive than the ELISPOT-based assay [37]. Theoretically, ELISPOT-based assay could be more useful in immunocompromised patients than ELISA-based assays.…”

Section: Discussionmentioning

confidence: 99%

Diagnostic usefulness of the cytomegalovirus (CMV)-specific T cell-based assay for predicting CMV infection after kidney transplant

Kim

Lee

Kim

et al. 2020

Korean J Intern Med

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Background/Aims: We evaluated the usefulness in kidney transplant (KT) candidates of cytomegalovirus (CMV)-specific enzyme-linked immunospot (ELISPOT) assays for predicting the development of post-transplant CMV infections. Methods: All adult recipients admitted for living-donor KT between March 2014 and March 2015 were prospectively enrolled except donor CMV-seropositive and recipient seronegative (D+/R-) recipients. All the enrolled patients underwent CMV-specific ELISPOT assays before transplant, and a researcher blinded to the results of these assays examined the patients for CMV infection at least 6 months post-transplant. Results: Of 133 KT recipients, 44 (33%) developed CMV infections. When we used the cutoff determined by receiver operator characteristic curve, 16 of the 34 patients (47%) with negative pp65-specific ELISPOT results (< 11 spots/200,000 cells) developed CMV infections, whereas 28 of the 99 patients (39%) with positive pp65-specific ELISPOT results at baseline (≥ 11 spots/200,000 cells) developed CMV infections after KT (p = 0.02). Based on the multivariable Cox regression model, negative pp65-specific ELISPOT assay results was an independent risk factor for CMV infection (adjusted hazard ratio [AHR], 1.87; 95% confidence interval [CI], 1.01 to 3.46; p = 0.047) as well as age (AHR, 1.05; 95% CI, 1.01 to 1.08; p = 0.007). Conclusions: Pre-transplant CMV-specific ELISPOT assay appears to predict the development of CMV infections after KT in recipients at moderate risk such as CMV-seropositive recipients (Clinical Trial Registration Number NCT 02025335).

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“…However, the actual prevalence of latent TB infection among controls is probably higher than what we found based on QFT-GIT test for two main reasons. First, the sensitivity of QFT-GIT test even in TB patients is low (24,25) suggesting that the test could miss a substantial proportion of controls with latent TB infection. Second, QFT-GIT test reversions over time are reported to be common among infected individuals (26,27) and QFT-GIT test has a low sensitivity in remotely infected individuals (28).…”

Section: Discussionmentioning

confidence: 99%

Lipoarabinomannan‐specific TNF‐α and IFN‐γ as markers of protective immunity against tuberculosis: a cohort study in an endemic setting

Belay

Legesse

Mihret

et al. 2015

APMIS

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Lipoarabinomannan (LAM) is a virulent factor used for entry and survival of Mycobacterium tuberculosis (Mtb) in macrophages. Although the role of LAM for the diagnosis of tuberculosis (TB) has been extensively investigated, its cytokine response during natural Mtb infection in humans is largely unknown. In this study, LAM-specific IFN-γ, TNF-α, and IL-10 levels following whole blood assay were measured in untreated pulmonary TB patients, their contacts and community controls at baseline. In treated patients and contacts, cytokines were also measured at 6 and 12 months. At entry, 52.8% and 74.8% of controls and contacts were QFT-GIT positive, respectively. At baseline, untreated TB patients and contacts had significantly lower IFN-γ and TNF-α response compared to community controls (p < 0.0001). Besides, untreated patients had significantly higher TNF-α and IL-10 response compared to their contacts (p < 0.0001). At 6 months, contacts and treated TB patients had significantly increased INF-γ and TNF-α response (p < 0.0001). In TB patients, IFN-γ increased 10-fold following chemotherapy suggesting its potential role for treatment monitoring. The data suggests that LAM might have an anti-inflammatory effect during clinical TB and early Mtb infection. The data also suggests that LAM-induced IFN-γ and TNF-α could be used as biomarkers of protective immunity.

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Is the Sensitivity of the QuantiFERON-TB Gold In-Tube Test Lower Than That of T-SPOT.TB in Patients With Miliary Tuberculosis?

Cited by 8 publications

References 6 publications

Prospective Comparison of QFT-GIT and T-SPOT.TB Assays for Diagnosis of Active Tuberculosis

Prospective Comparison of QFT-GIT and T-SPOT.TB Assays for Diagnosis of Active Tuberculosis

Diagnostic usefulness of the cytomegalovirus (CMV)-specific T cell-based assay for predicting CMV infection after kidney transplant

Lipoarabinomannan‐specific TNF‐α and IFN‐γ as markers of protective immunity against tuberculosis: a cohort study in an endemic setting

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