Sensitivity of Whole-Blood Interferon-Gamma Release Assay According to the Severity and the Location of Disease in Patients with Active Tuberculosis

Kim, Yi Young; Lee, Jaehee; Lee, Yoon Jee; Lee, So Yeon; Lee, Yong–Hun; Choi, Keum Ju; Hwangbo, Yup; Ick, Seung; Park, Jae Yong; Jung, Tae Hoon; Park, Jun Sik; Kim, Chang Ho

doi:10.4046/trd.2011.70.2.125

Cited by 4 publications

(4 citation statements)

References 23 publications

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“…Thus, it is likely that difference in the immune responses of the elderly, chronic disease, and severely-ill patients could have affected the result. In addition, Kim et al20 reported that the quantitative amount of IFN-γ secretion and the number of CD4+T cells secreting IFN-γ were inversely proportional to the severity of pulmonary TB, which was consistent with the results of previous studies. They also reported that the limited sensitivity of QFT was shown in severe pulmonary TB due to the high indeterminate rate (19.0%) in QFT20.…”

Section: Discussionsupporting

confidence: 89%

“…In addition, Kim et al20 reported that the quantitative amount of IFN-γ secretion and the number of CD4+T cells secreting IFN-γ were inversely proportional to the severity of pulmonary TB, which was consistent with the results of previous studies. They also reported that the limited sensitivity of QFT was shown in severe pulmonary TB due to the high indeterminate rate (19.0%) in QFT20. In this study, however, due to the small number of TB patients within the indeterminate group, no correlation of indeterminate results with the extent of TB lesion was found.…”

Section: Discussionsupporting

confidence: 89%

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Factors Associated with Indeterminate and False Negative Results of QuantiFERON-TB Gold In-Tube Test in Active Tuberculosis

Cho

Kwon

et al. 2012

Tuberc Respir Dis

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BackgroundThe sensitivities and specificities of interferon-gamma release assays (IGRAs) vary among different population studies, and the data on the routine use of IGRAs are limited. The aim of this study was to evaluate the role of QuantiFERON-TB Gold In-Tube (QFT-GIT) test in the diagnosis of active tuberculosis.MethodsWe conducted a prospective study, enrolling 77 patients with suspected pulmonary tuberculosis (TB), at a secondary care teaching hospital in Seoul.ResultsIn total, 12 (15.6%) patients showed indeterminate results due to positive control failure on the QFT-GIT test. Indeterminate results were significantly associated with the elderly, history of the intensive care unit stay, lymphocytopenia, especially low CD4 count, increased C-reactive protein and decreased protein levels. Of the 77 patients, 44 (57.1%) were diagnosed with active pulmonary tuberculosis, and the percentage of false negative results of the QFT-GIT was 36.4% (vs. 31.8% with TST). In the TB group with >65 years old (n=12), the proportions of the indeterminate (33.3% vs. 3.1%) and the false negative results (58.3% vs. 25.0%) of the QFT-GIT were significantly higher than in the younger TB group (n=32).ConclusionIndeterminate and false negative results of QFT-GIT test were not infrequent in tuberculosis, especially in the elderly. Care should be considered for the interpretation with the elderly, immunocompromised, chronic and severely diseased patients.

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Section: Discussionsupporting

confidence: 89%

Section: Discussionsupporting

confidence: 89%

Factors Associated with Indeterminate and False Negative Results of QuantiFERON-TB Gold In-Tube Test in Active Tuberculosis

Cho

Kwon

et al. 2012

Tuberc Respir Dis

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“…Also nearby results were reported by Lee et al (35) as sensitivity of the test was 78% and specificity was 79%. But in another study of Kim et al (36) ,lower sensitivity and specificity (70.1% and 64.3% respectively) of QuantiFERON test were reported and were attributed to the difference in radiographic extent of the disease and its location. Also immunological state and other biological factors may interfere and lead to different results (34) .…”

Section: Discussionmentioning

confidence: 89%

Evaluation of QuantiFERON-TB Gold in Diagnosis of Tuberculous Pericardial Effusion

Mohamed¹,

Mohamed²,

Elaziz³

2012

EJMM

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Background: Prompt treatment of tuberculous pericarditis can save lives, but definite diagnosis requires detection and isolation of the tubercle bacilli from pericardial fluid and/or biopsy which is often delayed and difficult. Objectives: To evaluate the diagnostic role of QuantiFERON-TB Gold test (QFT-G) as a rapid non invasive immunological assay in diagnosis of tuberculous pericarditis with pericardial effusion in comparison to Adenosine deaminase enzyme (ADA) activity and Polymerase chain reaction (PCR) either individually or in combination. Subjects and methods: 27 patients suffering of pericarditis accompanied with pericardial effusions highly suspicious to be tuberculous (clinically and radiographically) were subjected to pericardial fluid aspiration and biopsy, Ziehl-Neelsen stain, culture and histopathological examination(biopsy) for tuberculosis were done for each sample. Pericardial fluid was submitted to Polymerase chain reaction and measurement of adenosine deaminase activity and finally QuantiFERON-TB Gold test in blood was done. Results: Out of 27 probable tuberculous pericarditis patients with pericardial effusion, 19 were definite positive cases. Considering the value of 40 U/L ADA activity , 16/19 cases were positive so the sensitivity was 84.2% which was the same as the results of QuantiFERON-TB Gold test while there were 10 PCR positive cases, so PCR sensitivity was 52.6%. There were 2 positive ADA and one QuantiFERON-TB Gold positive results among the 8 culture negative cases, while none was detected by PCR , so its specificity was100% while (QFT-G) specificity was 87.5% and ADA 75%. The sensitivity, specificity, PPV and NPV of combined QFT-G test and PCR results were 89.5%, 87.5%, 94.4% and 77.8% respectively. While the sensitivity, specificity, PPV and NPV combined QFT-G with ADA results were 84.2%, 75%, 88.9% and 66.7% respectively. Conclusion: QuantiFERON-TB Gold test have good sensitivity and specificity for diagnosis of tuberculous pericardial effusion. The best combined sensitivity and specificity in the current study were reported between PCR and QuantiFERON test results but it is not much greater than that of QuantiFERON test alone. So, QuantiFERON-TB Gold test can be used as an adjunct rapid immunological non invasive test for diagnosis of tuberculous pericardial effusion. However negative QuantiFERON-TB Gold assay does not exclude the disease because of the low NPV of this assay.

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“…Interferon‐gamma (IFN‐γ) release assay tests were originally developed on the principle of quantitatively evaluating IFN‐γ production by peripherally circulating antigen‐specific effector memory T‐cells upon in vitro stimulation, in order to aid the diagnosis of M. bovis TB (bTB) in cattle, where it has a reported sensitivity of 81.8%–100% and specificity of 88%–99% (Bezos et al., ; Schiller et al., ; Vordermeier et al., ; Wood & Jones, ). They have subsequently been adapted to identify active and latent TB in human patients with at least equivalent sensitivity and increased specificity compared to the tuberculin skin test, as well as being practically easier to perform (Eisenhut, ; Kim et al., ; Thillai, Pollock, Pareek, & Lalvani, ; Zhou et al., ). An IGRA test has been validated for use in domestic cats with up to 100% sensitivity for the detection of MTBC infections (Rhodes, Gruffydd‐Jones, Gunn‐Moore, & Jahans, , ; Rhodes et al., ).…”

Section: Outbreak Investigationmentioning

confidence: 99%

An outbreak of tuberculosis due toMycobacterium bovisinfection in a pack of English Foxhounds (2016-2017)

O’Halloran

Hope

Dobromylskyj³

et al. 2018

Transbound Emerg Dis

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Mycobacterium bovis can cause tuberculosis (TB) in social mammals including lions, cattle and man, but canine infections are considered rare. In 2016/17 we investigated a M. bovis TB outbreak in a pack of approximately 180 Foxhounds within the bovine TB Edge Area of England. We employed a combination of immunological tests including an interferon gamma release assay (IGRA) and a serological assay (DPP VetTB, Chembio). Test‐positive hounds were euthanased and subjected to post‐mortem examination (PME). Overall 164 hounds were tested; 97 (59%) responded positively to at least one test. Eighty‐five (52%) dogs responded to M. bovis antigens by IGRA while only 21 (12.9%) had detectable serological responses. At PME three hounds (3.1%) had visible lesions (VL) due to M. bovis infection, later confirmed by culture. Samples from 24 non‐VL hounds were cultured and M. bovis infection was confirmed in a further three hounds (11%). This study is the first investigation and report of an outbreak of M. bovis TB in a canine species. We establish that, in principle, diagnostic tests used for identifying infected individuals of other species can effectively be used in the dog. Further work is urgently needed to establish the sensitivity and specificity of the testing approach used in this study for future clinical application.

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Sensitivity of Whole-Blood Interferon-Gamma Release Assay According to the Severity and the Location of Disease in Patients with Active Tuberculosis

Cited by 4 publications

References 23 publications

Factors Associated with Indeterminate and False Negative Results of QuantiFERON-TB Gold In-Tube Test in Active Tuberculosis

Factors Associated with Indeterminate and False Negative Results of QuantiFERON-TB Gold In-Tube Test in Active Tuberculosis

Evaluation of QuantiFERON-TB Gold in Diagnosis of Tuberculous Pericardial Effusion

An outbreak of tuberculosis due toMycobacterium bovisinfection in a pack of English Foxhounds (2016-2017)

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