Comparison of the Sensitivity of QuantiFERON-TB Gold In-Tube and T-SPOT.TB According to Patient Age

Bae, Woo Kyung; Park, Kyoung Un; Song, Eun Young; Kim, Sejoong; Lee, Yeon Joo; Cho, Young Jae; Yoon, Ho Il; Yim, Jae Joon; Lee, Choon Taek; Lee, Jae Ho

doi:10.1371/journal.pone.0156917

Cited by 39 publications

(41 citation statements)

References 37 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: 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: 99%

“…One disadvantage of interferon-γ assays is that they can yield ITRs. Previous studies found that ITRs were common (ranging from 0% to 20%) when using QFT-GIT assay 14 , 15 , 26 , 28 , 34 . However, the majority of them were associated with immunosuppression or old age.…”

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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“…Considering the prevalence of LTBI in the Republic of Korea and the importance of screening for LTBI in immunocompromised patients, who have an increased risk of M. tuberculosis reactivation after therapeutic interventions, the diagnostic performance of the screening methods is paramount. The overall sensitivity of QFT-GIT for the diagnosis of active tuberculosis infection in the Republic of Korean population has been reported to be 80.2% by Bae et al (30). However, the sensitivity or specificity of IGRAs for predicting the development of active tuberculosis is rather limited due to the need for long-term follow-up in the absence of a new exposure episode.…”

Section: Qft-plus (Concn In Tb2 Minus Concn In Nil Tube)mentioning

confidence: 99%

Comparative Evaluation of QuantiFERON-TB Gold In-Tube and QuantiFERON-TB Gold Plus in Diagnosis of Latent Tuberculosis Infection in Immunocompromised Patients

et al. 2018

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QuantiFERON-TB Gold Plus (QFT-Plus) is a new-generation QuantiFERON-TB Gold In-Tube (QFT-GIT) assay which has two antigen-coated tubes called TB1, which contains long peptides derived from ESAT-6 and CFP-10, and TB2, which contains the same components as TB1 and additional short peptides which potentially stimulate CD8 T cells through the presentation of major histocompatibility complex class I. This is the first study to compare QFT-Plus and QFT-GIT for use in the diagnosis of latent tuberculosis infection (LTBI) among immunocompromised patients in the Republic of Korea. Among 317 consecutive patients who underwent screening for LTBI before solid organ or hematopoietic stem cell transplantation and tumor necrosis factor alpha inhibitor treatment, LTBI was identified in 92 (29.0%) and 88 (27.8%) patients by QFT-GIT and QFT-Plus, respectively. The rate of concordance between QFT-GIT and QFT-Plus was 93.7% (κ value, 0.860), and the indeterminate rate (3.2%) was similar between QFT-GIT and QFT-Plus. Of 20 (6.3%) samples with discordant results, 11 (55.0%) and 7 (35.0%) were positive by QFT-GIT alone and QFT-Plus alone, respectively, and 2 (15.0%) were indeterminate by each assay. The interferon gamma level in samples with discordant results ranged from 0.39 to 1.10 IU/ml, except for one sample, in which the gamma interferon level was 2.97 IU/ml only in TB2. Conclusively, there was a high degree of agreement between the results of QFT-GIT and QFT-Plus for the screening of immunocompromised patients for LTBI. The reactivity in TB2 contributed substantially to the difference between QFT-GIT and QFT-Plus, particularly in solid organ transplant candidates. The significance of the discrete responses in TB1 and TB2 of QFT-Plus needs to be explored further by means of an immunological and clinical approach in different patient groups and clinical settings.

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“…More recently, several companies have developed blood tests known as interferon-gamma release assays (IGRAs) as an alternative to TST in screening for LTBI. 19 – 21 These assays employ the innate ability of T cells to release interferon gamma in response to exposure to specific antigens. QuantiFERON-TB Gold In-Tube (QFT-GIT) assay is an IGRA that uses ELISA to quantify interferon-gamma release in vitro when patient’s whole blood is exposed to a cocktail of 3 mycobacterial proteins (ESAT-6, CFP-10, and TB 7.7).…”

Section: Introductionmentioning

confidence: 99%

The conundrum of indeterminate QuantiFERON-TB Gold results before anti-tumor necrosis factor initiation

Hakimian¹,

Popov²,

Rupawala

et al. 2018

BTT

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BackgroundTumor necrosis factor alpha (TNFα) is a key cytokine in both the pathogenesis of inflammatory bowel disease (IBD) and rheumatoid arthritis (RA) and the host defense against tuberculosis (TB). Consequently, anti-TNFα medications result in an increased risk of latent TB infection (LTBI) reactivation. Here, we sought to evaluate the factors affecting the results of QuantiFERON-TB Gold In-Tube (QFT-GIT) assay as a screening tool for LTBI.MethodsWe conducted an observational, retrospective study in patients with IBD and RA who underwent LTBI screening using QFT-GIT at UMass Memorial Medical Center between 2008 and 2016 prior to initiation of anti-TNF medications.ResultsWe included 107 and 89 patients with IBD and RA, respectively. We found that a higher proportion of IBD patients had indeterminate QFT-GIT result compared to RA patients. Furthermore, we found that the majority of patients with indeterminate results were tested during an acute flare of IBD (88%) and while taking corticosteroids. Of all patients receiving ≥20 mg equivalent prednisone dose (n=32), 63% resulted in indeterminate QFT-GIT, compared to only 6% indeterminate testing in patients receiving <20 mg of equivalent prednisone dose (n=164, P<0.001). There was no correlation between indeterminate results and age, gender, disease duration, or distribution, or smoking status within each population.ConclusionWe observed that high-dose corticosteroids may affect QFT-GIT outcomes leading to a high proportion of indeterminate results. We propose that IBD patients should be tested prior to initiation of corticosteroids to avoid equivocal results and prevent potential delays in initiation of anti-TNF medications.

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Comparison of the Sensitivity of QuantiFERON-TB Gold In-Tube and T-SPOT.TB According to Patient Age

Cited by 39 publications

References 37 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

Comparative Evaluation of QuantiFERON-TB Gold In-Tube and QuantiFERON-TB Gold Plus in Diagnosis of Latent Tuberculosis Infection in Immunocompromised Patients

The conundrum of indeterminate QuantiFERON-TB Gold results before anti-tumor necrosis factor initiation

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