Article

Low Sensitivity of a Whole-Blood Interferon-γ Release Assay for Detection of Active Tuberculosis

International Research and Programs Branch, Division of Tuberculosis Elimination, National Center for HIV, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA.
Clinical Infectious Diseases (Impact Factor: 9.42). 02/2007; 44(1):69-73. DOI: 10.1086/509928
Source: PubMed

ABSTRACT The sensitivity of an interferon-gamma assay (Quantiferon-TB Gold; Cellestis) was evaluated for the detection of tuberculosis among 242 persons with suspected tuberculosis in San Francisco, California. Thirty-seven subjects had culture-confirmed tuberculosis. Excluding 1 indeterminate result, 23 (64%; 95% confidence interval, 48%-78%) of 36 subjects had positive results using the QuantiFERON-TB Gold assay. The 64% sensitivity suggests that the QuantiFERON-TB Gold assay should not be used alone to exclude active tuberculosis.

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    ABSTRACT: The specificity of the tuberculin skin test (TST) in the diagnosis of tuberculosis infection is seriously compromised because of extensive use of the bacille Calmette-Guérin (BCG) vaccination. The interferon-gamma release assay (IGRA), a new diagnostic using Mycobacterium tuberculosis-specific antigens has been introduced in response to these needs. In this review, published findings on the performance of the QuantiFERON-TB (QFT), one of the IGRA formats, are summarized and discussed. In addition to its high specificity, the QFT has considerably high sensitivity, comparable with or superior to that of the TST, if applied to patients with active tuberculosis as a surrogate of latent tuberculosis infection. When applied to patients with immunosuppression, such as aging patients, or those with HIV infection, those with immunosuppressive drug therapies, or those with renal hemodialysis, QFT is shown to be more robust than the TST. As regards the dynamics of QFT responses to chemotherapy, there are many reports showing a decrease in responses during the treatment, which indicates the possibility that QFT could be used as a tool for monitoring the progress of treatment. However, there are discordant reports that warrant further study.
    Journal of Infection and Chemotherapy 07/2009; 15(3):143-55. DOI:10.1007/s10156-009-0686-8 · 1.38 Impact Factor
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