Frequency and significance of indeterminate and borderline Quantiferon Gold TB IGRA results

Brown, James; Kumar, Kartik; Reading, Jacob; Harvey, Joanne E.; Murthy, Saraswathi; Capocci, Santino; Hopkins, Susan; Seneviratne, Suranjith L.; Cropley, Ian; Lipman, Marc

doi:10.1183/13993003.01267-2017

Cited by 26 publications

(26 citation statements)

References 15 publications

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“…1. This reassessment may be supported by previous study suggesting a change in IGRA result after months from the indeterminate result [10].…”

Section: Discussionsupporting

confidence: 83%

“…Being a retrospective analysis of aggregated data, many confounders may have been overlooked, including the presence of chronic rheumatologic or systemic diseases or acute conditions known to affect IGRA results [10]. Nevertheless, we believe that COVID-19-driven immune disturbance (both quantitative and qualitative) plays a major role due the high number of indeterminate IGRA testing.…”

Section: Discussionmentioning

confidence: 99%

“…In general, IGRA testing may results indeterminate in 2-11% of cases, particularly in subjects with chronic conditions such as rheumatologic or immunosuppressive states [10]. Furthermore, a low lymphocyte count is a well-known potential cause of false-negative TST and/or indeterminate IGRA results, the latter due to an insufficient immune response to the mitogen control [11,12].…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Preliminary observations on IGRA testing for TB infection in patients with severe COVID-19 eligible for immunosuppressive therapy

Torre

Aliberti

Castellotti

et al. 2020

Respiratory Medicine

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“…1. This reassessment may be supported by previous study suggesting a change in IGRA result after months from the indeterminate result [10].…”

Section: Discussionsupporting

confidence: 83%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Preliminary observations on IGRA testing for TB infection in patients with severe COVID-19 eligible for immunosuppressive therapy

Torre

Aliberti

Castellotti

et al. 2020

Respiratory Medicine

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“…This supports previous evidence (31)(32)(33); and together, the results suggest that we should now move on from investigating whether vitamin D can improve the outcome of treatment for TB disease, when given with standard TB therapy. It will be important to determine the implications of conversion values in the uncertainty zone with respect to clinical utility, the timing of re-testing, and TB risk in further independent cohorts (36).…”

Section: Diagnosis and Treatment Of Active Tb Diseasementioning

confidence: 99%

Update in Tuberculosis and Nontuberculous Mycobacteria 2017

Abubakar¹,

Rk²,

Rangaka³

et al. 2018

Am J Respir Crit Care Med

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“…It is known that the blood collection time, the blood volume, and processing delay can affect the QFT-GIT results and that the between-run reproducibility is poor [6]. Regarding QFT-GIT results in the borderline zone, short-term follow-up showed usefulness [11,20,22]. One HCW with borderline negative QFT-GIT results developed TB after one year.…”

Section: Plos Onementioning

confidence: 99%

The use of a borderline zone for the interpretation of interferon-gamma release assay results for serial screening of healthcare workers

et al. 2020

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Objective An interferon-gamma release assay (IGRA) is used to screen for latent tuberculosis infection (LTBI). Among IGRAs, the QuantiFERON-TB Gold In-Tube (QFT-GIT) results are highly variable, so the borderline zone has been proposed to reduce unnecessary LTBI treatment. The aim of this study was to examine the proportion of the borderline zone of QFT-GIT in healthcare workers' (HCWs) serial IGRA and to retrospectively identify the utility of predicting tuberculosis (TB) in a moderate TB incidence setting. Methods The participants were HCWs who had undergone serial LTBI screening between June 2013 and June 2018. IGRA-positive HCWs underwent examinations that included low-dose computed tomography (LDCT) and TB culture, if necessary. Applying the borderline zone (0.2-<0.7 IU/mL), the results were classified as definite negative, borderline negative, borderline positive and definite positive. Results Through the follow-up of 477 HCWs, 441 (92.5%) invariant, 30 (6.3%) conversion, 2 (0.4%) reversion and 5 (1.0%) indeterminate results were observed with the manufacturer's cutoff. Applying the borderline zone, 419 (87.8%) invariant, 22 (4.6%) conversion, 1 (0.2%) reversion and 36 (7.5%) decision pending, including 5 (1.0%) indeterminate results, were observed. At the time of screening, five TB cases were identified. Chest X-ray (CXR) identified one TB case, and LDCT identified four additional TB cases. After one year, two TB cases were diagnosed, and their screening QFT-GIT results were definite positive and borderline negative. In the Cochran-Armitage trend test, the greater the maximum difference in

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Frequency and significance of indeterminate and borderline Quantiferon Gold TB IGRA results

Cited by 26 publications

References 15 publications

Preliminary observations on IGRA testing for TB infection in patients with severe COVID-19 eligible for immunosuppressive therapy

Preliminary observations on IGRA testing for TB infection in patients with severe COVID-19 eligible for immunosuppressive therapy

Update in Tuberculosis and Nontuberculous Mycobacteria 2017

The use of a borderline zone for the interpretation of interferon-gamma release assay results for serial screening of healthcare workers

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