Identification of Recent Tuberculosis Exposure Using QuantiFERON-TB Gold Plus, a Multicenter Study

Pérez‐Recio, Sandra; Pallarès, Natàlia; Grijota-Camino, Maria D; Sánchez-Montalvà, Adrián; Barcia, Laura; Campos-Gutiérrez, Silvia; Pomar, Virginia; Rabuñal-Rey, Ramón; Balcells, María Elvira; Gazel, Deniz; Montiel, Natalia; Vicente, Diego; Goić-Barišić, Ivana; Schӧn, Thomas; Paues, Jakob; Mareković, Ivana; Cacho-Calvo, Juana Begoña; Barać, Aleksandra; Goletti, Delia; García-Gasalla, Mercedes; Barcala, José María; Tórtola, Teresa; Anibarro, Luis; Suárez-Toste, Isabel; Moga, Esther; Gude-González, María José; Naves, Rodrigo; Karslığil, Tekin; Martin-Peñaranda, Tania; Stevanović, Goran; Trigo, Matilde; Rubio, Verónica; Karaoğlan, İlkay; Bayram, Nazan; Alcaide, Fernando; Tebé, Cristian; Santín, Miguel

doi:10.1128/spectrum.00972-21

Cited by 8 publications

(4 citation statements)

References 15 publications

(20 reference statements)

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“…The study was conducted among a total of 686 adults who were either contacts of microbiologically confirmed-TB patients (high risk), asylum seekers or people from abroad (intermediate risk) and individuals screened for TB infection prior to immune-suppressant therapy for immune-mediated inflammatory disease (low risk). There was a lack of association between an antigen tube differential ≥ 0.6IU/ml and the likelihood of recent TB exposure both in unadjusted and adjusted analyses [ 25 ].…”

Section: Discussionmentioning

confidence: 99%

Comparing patterns of recent and remote Mycobacterium tuberculosis infection determined using the QuantiFERON-TB Gold Plus assay in a high TB burden setting

Amofa-Sekyi,

Schaap,

Mureithi

et al. 2024

PLOS Glob Public Health

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One quarter of the world’s population is estimated to be infected with Mycobacterium tuberculosis. Identifying recent TB infection (TBI) offers an avenue to targeted TB preventative therapy provision, and prevention to disease progression. However, detecting recent TBI remains challenging. The QuantiFERON-TB Gold Plus assay (QFT-Plus) claims to have improved sensitivity in detecting recent TBI, by the addition of the TB2 antigen tube to the TB1 tube used in previous tests. TB2 detects CD8-mediated interferon gamma response, a potential marker of recent infection. We compared QFT-Plus TB1 and TB2 responses in individuals with recent and remote infection in high-burden settings. The Tuberculosis Reduction through Expanded Antiretroviral Treatment and TB Screening (TREATS) Project followed a cohort of adolescents and young people (AYP) aged 15–24 years in Zambia and South Africa to determine TBI incidence measured by QFT-Plus over 24 months. We categorised individuals with QTF-Plus positive result into recent and remote infection. We compared their TB1 and TB2 responses and the antigen tube differential [TB2-TB1], an indicator of CD8-activity, using logistic regression. At baseline, 3876 AYP, 1852/3876 (47.8%) were QFT-Plus positive whilst 2024/3876 (52.2%) QFT-Plus negative. Of the QFT-Plus baseline positives, 1069/1852 (57.7%) tested positive at both 12 and 24 months—remote infection. Of the QFT-Plus baseline negatives, 274/2024(13.3%) converted within a 12-month period- recent infection. TB1 and TB2 responses were higher in remote than recent infection. In recent infection, TB2 responses were greater than TB1 responses. The mean differential was 0.01 IU/ml in recent and -0.22 IU/ml in remote infection, (p = 0.145). The quantitative QFT-Plus results did not appear to reflect a marked distinction between recent and remote infection. Further analysis of the responses of infected individuals who developed disease is required to determine whether any signal in QFT-Plus results may predict progression to disease.

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Section: Discussionmentioning

confidence: 99%

Comparing patterns of recent and remote Mycobacterium tuberculosis infection determined using the QuantiFERON-TB Gold Plus assay in a high TB burden setting

Amofa-Sekyi,

Schaap,

Mureithi

et al. 2024

PLOS Glob Public Health

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“…However, this study could not show an association with recent TB infection, as specific information on TB exposure or risk factors and data on LTBI serial testing were not available. It has recently been reported that QFT-Plus cannot distinguish between recent and past infections, suggesting that it should not be used for contact tuberculosis tracing 23 . This might indicate the need for further evidence.…”

Section: Discussionmentioning

confidence: 99%

QuantiFERON-TB Gold Plus and QuantiFERON-TB Gold In-tube assays for detecting latent tuberculosis infection in Thai healthcare workers

Rudeeaneksin

Srisungngam

Klayut

et al. 2023

Rev. Inst. Med. trop. S. Paulo

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Detecting latent tuberculosis infection (LTBI) is important, especially in high-risk populations including healthcare workers (HCWs). QuantiFERON-TB Gold Plus (QFT-Plus) is a new version of the interferon-gamma release assays (IGRAs) to replace the QuantiFERON-TB Gold In-tube (QFT-GIT). However, data on the use of QFT-Plus for LTBI detection in high TB-burden countries are limited. This study was conducted in a TB-endemic setting in Thailand. HCWs were enrolled in the study and underwent both tests during the annual health screening. The testing results were compared and the concordance was determined. Of 102 HCWs, 11 (10.78%) were positive according to both tests, and 15 (14.71%) were positive according to QFT-Plus. The overall agreement between assays was 96.08%, with Cohen’s kappa coefficient ( k ) at 0.82. All four discordant results occurred with QFT-GIT negative and QFT-Plus positive. The comparison between QFT-GIT and QFT-Plus based on each antigen tube (TB1 or TB2) exhibited similar concordance with 99.02% and 95.10% agreement, respectively. The intra-comparison between TB1 and TB2 of QFT-Plus also showed good concordance at 96.08%. Among this group of HCWs, the LTBI prevalence of any positive results in both tests was low. Overall, the study showed good agreement between QFT-Plus and QFT-GIT ( k = 0.82) with a minimal difference, suggesting similar assay performance to that mainly carried out in TB-low incidence countries. The results support the use of QFT-Plus for detecting LTBI in a format similar to QFT-GIT.

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“…Theoretically, the presence and strength of the CD8 response may help the clinical assessment of patients with new or active infections as it is usually shut off in old and not active diseases [ 47 ]. Nonetheless, some studies have failed to confirm the relationship between a high CD8 response and recent Mtb infection [ 48 ].…”

Section: Screening Tests For Tbimentioning

confidence: 99%

“…In mycobacterial infections, IFN-γ released by CD4 + T cells is essential for host survival and enhances both CD4 + and CD8 + T cell activities [ 129 ]. However, false-negative IGRA results were detected in patients with TB infection with advanced age [ 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 , 62 , 63 , 64 , 65 , 66 , 67 , 68 , 69 , 70 , 71 , 72 , 73 , 74 , 75 , 76 , 77 , 78 , 79 , 80 , 81 , 82 , 83 , 84 , 85 , 86 , 87 , 88 , 89 , 90 , 91 , 92 , …”

Section: Evaluation Of Host-derived Biomarkersmentioning

confidence: 99%

Challenges and the Way forward in Diagnosis and Treatment of Tuberculosis Infection

et al. 2023

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Globally, it is estimated that one-quarter of the world’s population is latently infected with Mycobacterium tuberculosis (Mtb), also known as latent tuberculosis infection (LTBI). Recently, this condition has been referred to as tuberculosis infection (TBI), considering the dynamic spectrum of the infection, as 5–10% of the latently infected population will develop active TB (ATB). The chances of TBI development increase due to close contact with index TB patients. The emergence of multidrug-resistant TB (MDR-TB) and the risk of development of latent MDR-TB has further complicated the situation. Detection of TBI is challenging as the infected individual does not present symptoms. Currently, there is no gold standard for TBI diagnosis, and the only screening tests are tuberculin skin test (TST) and interferon gamma release assays (IGRAs). However, these tests have several limitations, including the inability to differentiate between ATB and TBI, false-positive results in BCG-vaccinated individuals (only for TST), false-negative results in children, elderly, and immunocompromised patients, and the inability to predict the progression to ATB, among others. Thus, new host markers and Mtb-specific antigens are being tested to develop new diagnostic methods. Besides screening, TBI therapy is a key intervention for TB control. However, the long-course treatment and associated side effects result in non-adherence to the treatment. Additionally, the latent MDR strains are not susceptible to the current TBI treatments, which add an additional challenge. This review discusses the current situation of TBI, as well as the challenges and efforts involved in its control.

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Identification of Recent Tuberculosis Exposure Using QuantiFERON-TB Gold Plus, a Multicenter Study

Abstract: Contact tuberculosis tracing is essential to identify recently infected people, who therefore merit preventive treatment. However, there are no diagnostic tests that can determine whether the infection is a result of a recent exposure or not.

Cited by 8 publications

References 15 publications

Comparing patterns of recent and remote Mycobacterium tuberculosis infection determined using the QuantiFERON-TB Gold Plus assay in a high TB burden setting

Comparing patterns of recent and remote Mycobacterium tuberculosis infection determined using the QuantiFERON-TB Gold Plus assay in a high TB burden setting

QuantiFERON-TB Gold Plus and QuantiFERON-TB Gold In-tube assays for detecting latent tuberculosis infection in Thai healthcare workers

Challenges and the Way forward in Diagnosis and Treatment of Tuberculosis Infection

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