Interferon-γ release assays for the diagnosis of latent<i>Mycobacterium tuberculosis</i>infection

Diel, Roland; Goletti, Delia; Lange, Christoph; Manissero, Davide

doi:10.1183/09031936.00099111

Cited by 6 publications

(6 citation statements)

References 9 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Data regarding the performances of these tests for patients with potential LTBI are limited due to the absence of a gold standard for its diagnosis. Extrapolating from data studying the rate of progression to TB among TB contacts, similar results were obtained for both assays (3.3 to 10% for T-SPOT.TB assay versus 2.8 to 14.3% for QFT-GIT assay) (11). Conclusively, based on our data, no clear recommendation in favor of one or the other IGRA can be made with certainty at this point.…”

Section: Discussionmentioning

confidence: 46%

Comparison of Two Gamma Interferon Release Assays and Tuberculin Skin Testing for Tuberculosis Screening in a Cohort of Patients with Rheumatic Diseases Starting Anti-Tumor Necrosis Factor Therapy

Vassilopoulos

Tsikrika

Hatzara

et al. 2011

Clin Vaccine Immunol

View full text Add to dashboard Cite

Gamma interferon release assays (IGRAs) are increasingly used for latent Mycobacterium tuberculosis infection (LTBI) screening in patients with rheumatic diseases starting anti-tumor necrosis factor (anti-TNF) therapies. We compared the performances of two IGRAs, an enzyme-linked immunospot release assay (T-SPOT.TB) and an enzyme-linked immunosorbent assay (QuantiFERON-TB Gold In Tube [QFT-GIT]), to that of tuberculin skin testing (TST) for LTBI screening of 157 consecutive rheumatic patients starting anti-TNF therapies. Among 155 patients with valid results, 58 (37%) were positive by TST, 39 (25%) by T-SPOT.TB assay, and 32 (21%) by QFT-GIT assay. IGRAs were associated more strongly with at least one risk factor for tuberculosis (TB) than TST. Risk factors for a positive assay included chest X-ray findings of old TB (TST), advanced age (both IGRAs), origin from a country with a high TB prevalence, and a positive TST (T-SPOT.TB assay). Steroid use was negatively associated with a positive QFT-GIT assay. The agreement rate between IGRAs was 81% (kappa rate ‫؍‬ 0.47), which was much higher than that observed between an IGRA and TST. If positivity by either TST or an IGRA was required for LTBI diagnosis, then the rate of LTBI would have been 46 to 47%, while if an IGRA was performed only for TST-positive patients, the respective rate would have been 11 to 17%. In conclusion, IGRAs appear to correlate better with TB risk than TST and should be included in TB screening of patients starting anti-TNF therapies. In view of the high risk of TB in these patients, a combination of one IGRA and TST is probably more appropriate for LTBI diagnosis.The accurate diagnosis of latent Mycobacterium tuberculosis infection (LTBI) is critical for patients with various autoimmune diseases who are starting anti-tumor necrosis factor (anti-TNF) therapies, since the majority of tuberculosis (TB) cases developing in this population are due to LTBI reactivation (1.5 to 4 times increased risk) (18)(19)(20). Traditional methods for LTBI diagnosis, such as the tuberculin skin test (TST), have well-known limitations regarding their sensitivity and specificity for LTBI diagnosis (18)(19)(20). Over the last decade, different gamma interferon (IFN-␥) release assays (IGRAs) have been approved for LTBI diagnosis (13). These assays detect IFN-␥ secreted by peripheral mononuclear cells after in vitro stimulation with specific M. tuberculosis antigens not present in the M. bovis bacillus Calmette-Guérin (BCG) vaccine, either by enzyme-linked immunosorbent assay (ELISA) (QuantiFERON-TB Gold [QFT-G] and QuantiFERON-TB Gold In Tube [QFT-GIT] assays; Cellestis Limited, Carnegie, Victoria, Australia) or by enzyme-linked immunospot assay (T-SPOT.TB assay; Oxford Immunotec, Oxford, United Kingdom). Newer techniques for the diagnosis of LTBI or active TB based on the secretion of IFN-␥ after specific stimulation with specific M. tuberculosis antigens, such as the heparinbinding hemagglutinin (HBHA), have also shown promising results (28).Although there have b...

show abstract

Section: Discussionmentioning

confidence: 46%

Comparison of Two Gamma Interferon Release Assays and Tuberculin Skin Testing for Tuberculosis Screening in a Cohort of Patients with Rheumatic Diseases Starting Anti-Tumor Necrosis Factor Therapy

Vassilopoulos

Tsikrika

Hatzara

et al. 2011

Clin Vaccine Immunol

View full text Add to dashboard Cite

show abstract

“…In contrast to TST, IGRA is more specific for screening LTBI and is not affected by BCG vaccination. 6 Therefore, IGRA is considered superior to TST for detecting LTBI in countries with an intermediate to high burden of TB as well as in countries with high BCG vaccination rates.…”

Section: Introductionmentioning

confidence: 99%

Serial QuantiFERON-TB Gold In-Tube testing for psoriatic patients receiving antitumor necrosis factor-alpha therapy

Cheng

Hui

et al. 2015

Dermatologica Sinica

View full text Add to dashboard Cite

a b s t r a c tBackground/Objective: Tumor necrosis factor-a (TNF-a) antagonists have become increasingly popular in the treatment of psoriasis. However, the increased risk of latent tuberculosis infection (LTBI) reactivation has also become an important issue in clinical practice. The aim of this study was to evaluate serial QuantiFERON-TB Gold In-Tube (QFT-GIT) testing for detecting LTBI among a cohort of psoriatic patients vaccinated with bacille Calmette-Gu erin in a country with an intermediate burden of TB during longterm treatment with TNF-a antagonists. Methods: We enrolled psoriatic patients treated with TNF-a antagonists who also accepted yearly serial QFT-GIT testing and regular chest X-ray examinations before and during the anti-TNF-a treatment from January 2010 to August 2014. Patients diagnosed with LTBI received chemoprophylaxis, and QFT-GIT testing was performed in these patients after completion of chemoprophylaxis. Results: In this retrospective study, 101 patients had completed baseline and at least 1 year of follow-up. Among these patients, 60 had continued TNF-a antagonists therapy and received examinations in the 2 nd year, whereas 18 had continued the therapy until the 3 rd year. The conversion rate among these patients was 14.29% (13/91). In this study, 23 patients were diagnosed with LTBI according to the positive results obtained in the QFT-GIT test, with 19 of them having completed chemoprophylactic therapy. Follow-up QFT-GIT testing revealed reversion in 11 patients (57.89%) and decreased interferon-g (IFN-g) levels (68.42%) in 13 patients. Patients over 45 years of age tended to have a persistent positive result. Conclusion: This study demonstrated that 14.29% of psoriatic patients undergoing long-term TNF-a antagonist therapy had a QFT-GIT conversion. Although a decreased IFN-g level and QFT-GIT reversion were observed in most cases following prophylactic therapy, the value of QFT-GIT for evaluating the effect of LTBI prophylaxis remains controversial.

show abstract

“…Moreover, assessing immune responses circumvents the need to detect tubercle bacilli or their products, both of which are currently inaccessible during most of the asymptomatic infection and even during early symptomatic stages. Despite these considerations, no immunodiagnostic test exists that can accurately diagnose active TB, distinguish LTBI from active TB, or tell apart asymptomatic forms of infection that are associated with a high risk of disease progression (the shortcomings of TB immunodiagnostics have been extensively reviewed [36,38,134,142,143]). It is time to translate the complexities of the clinical spectrum of M. tuberculosis infection into new paradigms for TB immunodiagnosis.…”

Section: Introductionmentioning

confidence: 99%

Immunodiagnosis of Tuberculosis: a Dynamic View of Biomarker Discovery

Kunnath-Velayudhan¹,

Gennaro²

2011

Clin Microbiol Rev

View full text Add to dashboard Cite

SUMMARY Infection with Mycobacterium tuberculosis causes a variety of clinical conditions ranging from life-long asymptomatic infection to overt disease with increasingly severe tissue damage and a heavy bacillary burden. Immune biomarkers should follow the evolution of infection and disease because the host immune response is at the core of protection against disease and tissue damage in M. tuberculosis infection. Moreover, levels of immune markers are often affected by the antigen load. We review how the clinical spectrum of M. tuberculosis infection correlates with the evolution of granulomatous lesions and how granuloma structural changes are reflected in the peripheral circulation. We also discuss how antigen-specific, peripheral immune responses change during infection and how these changes are associated with the physiology of the tubercle bacillus. We propose that a dynamic approach to immune biomarker research should overcome the challenges of identifying those asymptomatic and symptomatic stages of infection that require antituberculosis treatment. Implementation of such a view requires longitudinal studies and a systems immunology approach leading to multianalyte assays.

show abstract

Interferon-γ release assays for the diagnosis of latentMycobacterium tuberculosisinfection

Cited by 6 publications

References 9 publications

Comparison of Two Gamma Interferon Release Assays and Tuberculin Skin Testing for Tuberculosis Screening in a Cohort of Patients with Rheumatic Diseases Starting Anti-Tumor Necrosis Factor Therapy

Comparison of Two Gamma Interferon Release Assays and Tuberculin Skin Testing for Tuberculosis Screening in a Cohort of Patients with Rheumatic Diseases Starting Anti-Tumor Necrosis Factor Therapy

Serial QuantiFERON-TB Gold In-Tube testing for psoriatic patients receiving antitumor necrosis factor-alpha therapy

Immunodiagnosis of Tuberculosis: a Dynamic View of Biomarker Discovery

Contact Info

Product

Resources

About