Comparison of IGRA tests and TST in the diagnosis of latent tuberculosis infection and predicting tuberculosis in risk groups in Krakow, Poland

Kruczak, Katarzyna; Duplaga, Mariusz; Sanak, Marek; Ćmiel, Adam; Mastalerz, Lucyna; Sładek, Krzysztof; Niżankowska‐Mogilnicka, Ewa

doi:10.3109/00365548.2014.927955

Cited by 19 publications

(12 citation statements)

References 17 publications

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“…Indeed, for smear-negative patients, QFT has been estimated to show sensitivity of 75% and specificity of only 37%, suggesting that the diagnostic accuracy of QFT is especially low in those patients [ 9 ]. TST is also widely used in diagnostic testing for LTBI [ 10 ], but TST has low sensitivity of 80% [ 11 ] in subjects who had been vaccinated with BCG, which is common in Japan. Therefore, our aim here was to elucidate if we could improve diagnosis of active TB simply by assaying for a larger number of cytokines in the QFT supernatant used to detect IFN-γ.…”

Section: Discussionmentioning

confidence: 99%

Combined Analysis of IFN-γ, IL-2, IL-5, IL-10, IL-1RA and MCP-1 in QFT Supernatant Is Useful for Distinguishing Active Tuberculosis from Latent Infection

et al. 2016

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The QuantiFERON®-TB Gold In-Tube test (QFT), an interferon-γ release assay, is used to diagnose Mycobacterium tuberculosis, but its inaccuracy in distinguishing active tuberculosis from latent infection is a major concern. There is thus a need for an easy and accurate tool for achieving that goal in daily clinical settings. This study aimed to identify candidate cytokines for specifically differentiating active tuberculosis from latent infection. Our study population consisted of 31 active TB (tuberculosis) patients, 29 LTBI (latent tuberculosis infection) patients and 10 healthy control subjects. We assayed for 27 cytokines in QFT supernatants of both specific antigen-stimulated blood samples (TBAg) and negative-control samples (Nil). We analyzed their specificities and sensitivities by creating receiver operating characteristic (ROC) curves and measuring the area under those curves (AUCs). In TBAg–Nil supernatants, IL-10, IFN-γ, MCP-1 and IL-1RA showed high AUCs of 0.8120, 0.7842, 0.7419 and 0.7375, respectively. Compared with each cytokine alone, combined assay for these top four cytokines showed positive rates in diagnosing active TB, and GDA analysis revealed that MCP-1 and IL-5 are potent in distinguishing active TB from LTBI, with Wilk’s lambda = 0.718 (p < 0.001). Furthermore, utilizing the unique characteristic of IL-2 that its TBAg–Nil supernatant levels are higher in LTBI compared to active TB, the difference between IFN-γ and IL-2 showed a large AUC of 0.8910. In summary, besides IFN-γ, IL-2, IL-5, IL-10, IL-1RA and MCP-1 in QFT supernatants may be useful for distinguishing active TB from LTBI. Those cytokines may also help us understand the difference in pathogenesis between active TB and LTBI.

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Section: Discussionmentioning

confidence: 99%

Combined Analysis of IFN-γ, IL-2, IL-5, IL-10, IL-1RA and MCP-1 in QFT Supernatant Is Useful for Distinguishing Active Tuberculosis from Latent Infection

et al. 2016

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“…Consequently, the risk of hospitalization due to infections (including TB) is higher in homeless persons than in the general population [11]. This is in line with a high prevalence of positive IGRA in homeless persons in Poland (36.7%), USA (12–40%), Japan (50.6%) and South Korea (75.9%) in non-outbreak settings [12–16].…”

Section: Introductionmentioning

confidence: 90%

“…Besides the close contact, the late state of disease at diagnosis is an important risk factor for ongoing transmission between homeless persons [18]. Noteworthy, the incidence rate of active TB in persons with positive IGRA is higher in homeless (30/1000 person-years) compared to close contacts to index cases (18/1000 person-years) [12]. Although homeless persons have a high risk of TB, the exact prevalence of LTBI in this population in Germany is unknown.…”

Section: Introductionmentioning

confidence: 99%

Prevalence of latent tuberculosis in homeless persons: A single-centre cross-sectional study, Germany

et al. 2019

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PurposeHomeless persons have a high risk for tuberculosis. The prevalence of latent tuberculosis infection and the risk for a progression to active tuberculosis is higher in the homeless than in the general population. The objective was to assess the prevalence and risk factors of tuberculosis/latent tuberculosis infection in a homeless population in Germany.MethodsHomeless individuals (n = 150) were enrolled in a cross-sectional study at three shelters in Münster, Germany (October 2017–July 2018). All participants were screened using an ELISPOT interferon-γ release assay (IGRA). Those participants tested positive/borderline by IGRA provided three sputa for microbiological analysis (line probe assay, microscopy, culture) and underwent a chest X-ray to screen for active pulmonary TB. Risk factors for tuberculosis/latent tuberculosis infection were analysed using a standardized questionnaire.ResultsOf the 142 evaluable IGRA, 21 (15%) were positive and two (1%) were borderline. No participant with a positive/borderline IGRA had an active tuberculosis as assessed by chest X-ray and microbiology. A negative IGRA was associated with a citizenship of a low-incidence country for tuberculosis (according to WHO, p = 0.01), low-incidence country of birth (p<0.001) or main residence in a low-incidence country in the past five years (p = 0.002).ConclusionsThe prevalence of latent tuberculosis infection (diagnosed by a positive/borderline IGRA) was 16%; no active tuberculosis was detected. The highest risk for latent tuberculosis infection was found in patients from high-incidence countries. This population at risk should be either treated for latent tuberculosis infection or need to be monitored to early detect a progression into active disease.

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“…Estudios realizados en México han confirmado una alta prevalencia de TB latente en trabajadores en contacto con animales positivos para M. bovis, representando un riesgo laboral (4). Como consecuencia, es imperioso direccionar investigaciones relacionadas con la prevalencia de la infección a través de metodologías como el test de tuberculina y la detección de interferón gama (IGRA, por sus siglas en inglés), que en otros trabajos han mostrado buena sensibilidad y especificidad para la identificación de estados de latencia (21,22).…”

Section: Resultsunclassified

Tuberculosis por Mycobacterium bovis en trabajadores de fincas en saneamiento para tuberculosis bovina, de Antioquia, Boyacá y Cundinamarca

Leal¹,

Castro²,

Wintaco-Martínez³

et al. 2017

Rev. salud pública

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Comparison of IGRA tests and TST in the diagnosis of latent tuberculosis infection and predicting tuberculosis in risk groups in Krakow, Poland

Abstract: The prevalence of positive QFT-GIT and TST was high in the study risk groups. The best predictor of active TB in the homeless and close contacts groups was a positive QFT-GIT together with a positive TST.

Cited by 19 publications

References 17 publications

Combined Analysis of IFN-γ, IL-2, IL-5, IL-10, IL-1RA and MCP-1 in QFT Supernatant Is Useful for Distinguishing Active Tuberculosis from Latent Infection

Combined Analysis of IFN-γ, IL-2, IL-5, IL-10, IL-1RA and MCP-1 in QFT Supernatant Is Useful for Distinguishing Active Tuberculosis from Latent Infection

Prevalence of latent tuberculosis in homeless persons: A single-centre cross-sectional study, Germany

Tuberculosis por Mycobacterium bovis en trabajadores de fincas en saneamiento para tuberculosis bovina, de Antioquia, Boyacá y Cundinamarca

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