Use of the QuantiFERON<sup>®</sup>-TB Gold in Tube test for screening TB contacts and predictive value for active TB

Yoshiyama, Takashi; Harada, Nobuyuki; Higuchi, Kazue; Saitou, Masami; Kato, Seiya

doi:10.3109/23744235.2015.1026935

Cited by 9 publications

(10 citation statements)

References 7 publications

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“…41 Adjusted values included a hazard ratio of 2.0 (95% CI 1.2 to 3.3), after adjustment for BCG vaccination scar, maternal education and current/prior household TB contact, 54 and an odds ratio of 14.9 (95% CI 2.77 to 80.3), adjusted for the number of IGRA-positive contacts of the same index case, receipt of treatment and place of contact (household vs. other). 76 These effect estimates varied considerably and were often imprecise. In addition, analyses of data from contacts often did not account for clustering by index case, and logistic regression did not account for differences in time at risk of developing active TB.…”

Section: Diagnostic Performance Of Interferon Gamma Release Assays Fomentioning

confidence: 99%

“…The pooled IRR (comparing individuals with a positive IGRA result with those with a negative result) from a previous meta-analysis was 2.11 (95% CI 1.29 to 3.46) for IGRA, 1.60 (95% CI 0.94 to 2.72) for TST with a 10-mm cut-off point and 1.43 (95% CI 0.75 to 2.72) for TST with a 5-mm cut-off point. 16 Results for IGRAs published since the systematic review 117 included hazard ratios ranging from 2.0 54 to 42.4, 29 odds ratios of 2.10-14.9 35,76 and rate ratios of 2.12-73.9. 24,75 Our estimates for T-SPOT.TB and QFT-GIT were 8.8 (95% CI 5.5 to 14.2) and 5.4 (95% CI 3.4 to 8.5), respectively; these were higher than the pooled estimate and broadly consistent with the less extreme estimates from the later studies.…”

Section: Comparison With Previous Estimates Of Interferon Gamma Releamentioning

confidence: 99%

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Two interferon gamma release assays for predicting active tuberculosis: the UK PREDICT TB prognostic test study

Abubakar

Lalvani

Southern

et al. 2018

Health Technol Assess

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Background Despite a recent decline in the annual incidence of tuberculosis (TB) in the UK, rates remain higher than in most Western European countries. The detection and treatment of latent TB infection (LTBI) is an essential component of the UK TB control programme. Objectives To assess the prognostic value and cost-effectiveness of the current two interferon gamma release assays (IGRAs) compared with the standard tuberculin skin test (TST) for predicting active TB among untreated individuals at increased risk of TB: (1) contacts of active TB cases and (2) new entrants to the UK from high-TB-burden countries. Design A prospective cohort study and economic analysis. Participants and setting Participants were recruited in TB clinics, general practices and community settings. Contacts of active TB cases and migrants who were born in high-TB-burden countries arriving in the UK were eligible to take part if they were aged ≥ 16 years. Main outcome measures Outcomes include incidence rate ratios comparing the incidence of active TB in those participants with a positive test result and those with a negative test result for each assay, and combination of tests and the cost per quality-adjusted life-year (QALY) for each screening strategy. Results A total of 10,045 participants were recruited between May 2010 and July 2015. Among 9610 evaluable participants, 97 (1.0%) developed active TB. For the primary analysis, all test data were available for 6380 participants, with 77 participants developing active TB. A positive result for TSTa (positive if induration is ≥ 5 mm) was a significantly poorer predictor of progression to active TB than a positive result for any of the other tests. Compared with TSTb [positive if induration is ≥ 6 mm without prior bacillus Calmette–Guérin (BCG) alone, T-SPOT®.TB (Oxford Immunotec Ltd, Oxford, UK), TSTa + T-SPOT.TB, TSTa + IGRA and the three combination strategies including TSTb were significantly superior predictors of progression. Compared with the T-SPOT.TB test alone, TSTa + T-SPOT.TB, TSTb + QuantiFERON® TB Gold In-Tube (QFT-GIT; QIAGEN GmbH, Hilden, Germany) and TSTb + IGRA were significantly superior predictors of progression and, compared with QFT-GIT alone, T-SPOT.TB, TSTa + T-SPOT.TB, TSTa + QFT-GIT, TSTa + IGRA, TSTb + T-SPOT.TB, TSTb + QFT-GIT and TSTb + IGRA were significantly superior predictors of progression. When evaluating the negative predictive performance of tests and strategies, negative results for TSTa + QFT-GIT were significantly poorer predictors of non-progression than negative results for TSTa, T-SPOT.TB and TSTa + IGRA. The most cost-effective LTBI testing strategies are the dual-testing strategies. The cost and QALY differences between the LTBI testing strategies were small; in particular, QFT-GIT, TSTb + T-SPOT.TB and TSTb + QFT-GIT had very similar incremental net benefit estimates. Conclusion This study found modest differences between tests, or combinations of tests, in identifying individuals who would go on to develop active TB. However, a two-step approach that combined TSTb with an IGRA was the most cost-effective testing option. Implications for practice and future research The two-step TSTb strategy, which stratified the TST by prior BCG vaccination followed by an IGRA, was the most cost-effective approach. The limited ability of current tests to predict who will progress limits the clinical utility of tests. The implications of these results for the NHS England/Public Health England national TB screening programme for migrants should be investigated. Study registration This study is registered as NCT01162265. Funding The National Institute for Health Research Health Technology Assessment programme.

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Section: Diagnostic Performance Of Interferon Gamma Release Assays Fomentioning

confidence: 99%

Section: Comparison With Previous Estimates Of Interferon Gamma Releamentioning

confidence: 99%

Two interferon gamma release assays for predicting active tuberculosis: the UK PREDICT TB prognostic test study

Abubakar

Lalvani

Southern

et al. 2018

Health Technol Assess

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“…Fifteen studies with a combined sample size of 26,680 participants were included in this analysis (107)(108)(109)(110)(111)(112)(113)(114)(115)(116)(117)(118)(119)(120)(121). The incidence of active TB during a median follow-up of 3 years was 2 to 24 per 1,000 person-years for IGRA-negative individuals (Fig.…”

Section: Predictive Value For Progression To Tb Diseasementioning

confidence: 99%

Gamma Interferon Release Assays for Detection of Mycobacterium tuberculosis Infection

et al. 2014

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SUMMARY Identification and treatment of latent tuberculosis infection (LTBI) can substantially reduce the risk of developing active disease. However, there is no diagnostic gold standard for LTBI. Two tests are available for identification of LTBI: the tuberculin skin test (TST) and the gamma interferon (IFN-γ) release assay (IGRA). Evidence suggests that both TST and IGRA are acceptable but imperfect tests. They represent indirect markers of Mycobacterium tuberculosis exposure and indicate a cellular immune response to M. tuberculosis . Neither test can accurately differentiate between LTBI and active TB, distinguish reactivation from reinfection, or resolve the various stages within the spectrum of M. tuberculosis infection. Both TST and IGRA have reduced sensitivity in immunocompromised patients and have low predictive value for progression to active TB. To maximize the positive predictive value of existing tests, LTBI screening should be reserved for those who are at sufficiently high risk of progressing to disease. Such high-risk individuals may be identifiable by using multivariable risk prediction models that incorporate test results with risk factors and using serial testing to resolve underlying phenotypes. In the longer term, basic research is necessary to identify highly predictive biomarkers.

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“…Серед пацієнтів із позитивним КФТ упродовж періоду спостереження була виявлена активна форма туберкульозу в 10 осіб (6 %), а в групі з негативним КФТ захворіли на активну форму туберкульозу 2 пацієнти (0,4 %). Отже, контактні особи з позитивним результатом КФТ мають більший ризик захворювання на активний туберкульоз, ніж особи з негативним КФТ, що підтверджує ефективність цього тесту для відбору осіб для проведення профілактичного лікування [16].…”

Section: квантифероновий тест для скринінгу на лтіunclassified

Латентна Туберкульозна Інфекція: Можливості Квантиферонового Тесту

Tlustova¹,

Kirilova²,

Kuzhko³

2021

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Review ОглядЗа даними ВООЗ, туберкульоз залишається однією з 10 провідних причин смерті у світі і є однією з провідних причин смерті серед ВІЛ-інфікованих. При цьому понад 95 % випадків смерті від туберкульозу реєструються в країнах із низьким і середнім рівнем прибутку [1]. Кінцевої метою ВООЗ на сьогодні є викоренення туберкульозу у всьому світі [2]. Захворюваність на туберкульоз у світі знижується на 1,5 % на рік, але для глобального викоренення туберкульозу такі темпи замалі. Експертами визначено, що досягти цієї мети неможливо, якщо займатись лише активними випадками туберкульозу й ігнорувати випадки латентної туберкульозної інфекції (ЛТІ). Глобальний звіт ВООЗ із туберкульозу за 2016 рік визначає, що лікування ЛТІ є ключовим фактором профілактики нових випадків активного туберкульозу [1,3].За визначенням ВООЗ, ЛТІ - це стан стійкої імунної відповіді на антигени мікобактерій туберкульозу (МБТ), що потрапили в організм раніше, за відсутності клінічних проявів активної форми туберкульозу [4].© «Актуальна інфектологія» / «Актуальная инфектология» / «Actual Infectology» (« »), 2018

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Use of the QuantiFERON^®-TB Gold in Tube test for screening TB contacts and predictive value for active TB

Abstract: Progression to TB among QFT-GIT-positive contacts was higher than among QFT-GIT-negative contacts. Other independent risk factors for progression to TB were index cases with more QFT-GIT-positive contacts as well as household contacts.

Cited by 9 publications

References 7 publications

Two interferon gamma release assays for predicting active tuberculosis: the UK PREDICT TB prognostic test study

Two interferon gamma release assays for predicting active tuberculosis: the UK PREDICT TB prognostic test study

Gamma Interferon Release Assays for Detection of Mycobacterium tuberculosis Infection

Латентна Туберкульозна Інфекція: Можливості Квантиферонового Тесту

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Use of the QuantiFERON®-TB Gold in Tube test for screening TB contacts and predictive value for active TB

Abstract: Progression to TB among QFT-GIT-positive contacts was higher than among QFT-GIT-negative contacts. Other independent risk factors for progression to TB were index cases with more QFT-GIT-positive contacts as well as household contacts.

Cited by 9 publications

References 7 publications

Two interferon gamma release assays for predicting active tuberculosis: the UK PREDICT TB prognostic test study

Two interferon gamma release assays for predicting active tuberculosis: the UK PREDICT TB prognostic test study

Gamma Interferon Release Assays for Detection of Mycobacterium tuberculosis Infection

Латентна Туберкульозна Інфекція: Можливості Квантиферонового Тесту

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Use of the QuantiFERON^®-TB Gold in Tube test for screening TB contacts and predictive value for active TB