Use of a T-cell-based test for detection of tuberculosis infection among immunocompromised patients

Piana, Federica; Codecasa, Luigi; Cavallerio, P.; Ferrarese, Maurizio; Migliori, Giovanni Battista; Barbarano, Luciana; Morra, Enrica; Cirillo, Daniela María

doi:10.1183/09031936.06.00110205

Cited by 105 publications

(63 citation statements)

References 20 publications

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“…To our knowledge, this is the largest study about the utility of the T-SPOT.TB among hematological malignancy patients and hematopoietic stem cell transplant recipients for detection of tuberculosis infection (Piana et al, 2006;Moon et al, 2013). Patients with hematological malignancy and receiving hematopoietic stem cell transplantation are both high-risk patients to get tuberculosis infection.…”

Section: Discussionmentioning

confidence: 99%

T-SPOT.TB for Detection of Tuberculosis Infection among Hematological Malignancy Patients and Hematopoietic Stem Cell Transplant Recipients

Qin¹,

Wang²,

Wang³

et al. 2013

Asian Pacific Journal of Cancer Prevention

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The diagnosis of latent Mycobacterium tuberculosis infection (LTBI) is recommended in hematological malignancy patients and before hematopoietic stem cell transplantation (Guidelines for the prevention and management of infectious complications of solid organ transplantation, 2004). Compared to traditional methods such as tuberculin skin test (TST), T-SPOT.TB has been shown to be more specific. In the present study we enrolled 536 patients for whom T-SPOT.TB was performed, among which 295 patients also received the TST test. The agreement (79%) between T-SPOT.TB and TST was poor (κ=0.274, P<0.001). The patients with positive T-SPOT.TB results numbered 62 (11.6%), in which only 20 (48.8%) of the 41 receiving the TST test had positive results. A majority of the patients with T-SPOT.TB positive results had some other evidence ofTB, such as TB history, clinical symptoms and an abnormal chest CT scan. Active TB was found in 9 patients, in which 2 had negative TST results. We followed up the patients and no one developed active TB. Our study suggested that the T-SPOT.TB may be more useful for screening LTBI and active TB in hematological malignancy patients and hematopoietic stem cell transplant recipients than the TST test.

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Section: Discussionmentioning

confidence: 99%

T-SPOT.TB for Detection of Tuberculosis Infection among Hematological Malignancy Patients and Hematopoietic Stem Cell Transplant Recipients

Qin¹,

Wang²,

Wang³

et al. 2013

Asian Pacific Journal of Cancer Prevention

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“…These tests with positive and nil internal controls are more specific than TST in diagnosing TB infection [3][4][5] and equally or more sensitive in patients with immune deficiencies. Nevertheless, indeterminate results have been reported for both tests with a frequency of 0-5.4% for the T-SPOT TM .TB test [6][7][8][9][10][11] and ,40% for the QuantiFERON1-TB Gold test [12][13][14][15][16][17]. Their occurrence seems to be associated with immunosuppression [10,18] and very young or very old age (patients aged ,5 or .80 yrs).…”

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confidence: 99%

Indeterminate test results of T-SPOTTM.TB performed under routine field conditions

Beffa

Zellweger²,

Janssens³

et al. 2008

European Respiratory Journal

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Interferon-c release assays for the diagnosis of tuberculosis (TB) Of a total of 1,429 tests, 49 (3.4%) were indeterminate. ITRs were significantly associated with old age (.75 versus 5-75 yrs; odds ratio (OR) 7.97, 95% confidence interval (CI) 3.968-15.438) and the season during which samples were transported (autumn and winter versus spring and summer; OR 3.47, 95% CI 1.753-7.514). The incidence of ITR was 302 (2.0%) among TB contacts, 75 (1.6%) among immigrants, 156 (3.0%) in TB suspects and 32 (3.0%) among immunosuppressed patients. Sex, young age and distance to the laboratory were not associated with the rate of ITR. Of the 13 tests with ITR that were repeated, 10 gave a clear positive or negative result.Indeterminate test results with T-SPOT TM .TB under routine conditions were infrequent and more common in individuals aged .75 yrs than in children and younger adults. The incidence of indeterminate test results was low and similar among healthy tuberculosis contacts, immigrants with a positive tuberculin skin test, tuberculosis suspects and the immunosuppressed. The conditions of transportation may influence the incidence of indeterminate test results.

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“…In terms of sensitivity, there are several studies that showed that the IGRAs are more sensitive than the TST. 15,102,103,106 Ponce de Leon et al 15 recently showed that, in a population from an endemic area for TB, the ELISPOT was significantly more sensitive than the TST for diagnosis of latent TB in patients with rheumatoid arthritis, but the same result was not found in healthy patients. Such finding probably was associated with immunosuppression of the disease and/or medication used in the disease treatment.…”

Section: Elispot (Available In the Market As T-spottb ® Oxfordmentioning

confidence: 78%

“…[98][99][100] Ferrara et al 79 found high rate of undetermined results Other studies have shown that the prevalence of positive ELISPOT results was higher than that found using the TST, mainly in immunosuppressed patients. 16,102,103 79 suggested that IGRAs specificity is higher than TST specificity for the diagnosis of tuberculosis infection.…”

Section: Elispot (Available In the Market As T-spottb ® Oxfordmentioning

confidence: 99%

O desafio da tuberculose na faixa etária pediátrica frente a novas técnicas diagnósticas

Sztajnbok

Boecha

Sztajnbok

et al. 2009

J. Pediatr. (Rio J.)

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Objectives: To present an updated review concerning new assays for diagnosing tuberculosis based on in vitro interferon-gamma production by host T cells, and to compare them with tuberculin skin test.Sources: A literature review was carried out based on MEDLINE and LILACS databases (2000-2008) searching for the following keywords: tuberculosis, interferon-gamma, quantiFERON, ELISPOT and T-SPOT.TB. Summary of the findings:These new assays proved to have, in general, equal or superior sensitivity and specificity than the tuberculin skin test not only in adults but also in children and immunosuppressed patients for the diagnosis of both latent tuberculosis infection or active disease, with some advantages such as less cross-reactivity as a result of previous BCG vaccination, less influence of anergy and better accuracy in small children. In the United States, these assays have been used instead of the tuberculin skin test and, although still very expensive, the World Health Organization will be making its economic viability a priority. Conclusions:Always having in mind the importance of clinical and epidemiological histories, these new assays based on interferon-gamma release present promising results and should be considered in tuberculosis investigation procedures for all patients, however with a special concern in the risk groups (i.e., children and immunosuppressed patients).J Pediatr (Rio J). 2009;85(3):183-193: Tuberculosis, interferon-gamma, quantiFERON, ELISPOT, children, immunosuppression.

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Use of a T-cell-based test for detection of tuberculosis infection among immunocompromised patients

Cited by 105 publications

References 20 publications

T-SPOT.TB for Detection of Tuberculosis Infection among Hematological Malignancy Patients and Hematopoietic Stem Cell Transplant Recipients

T-SPOT.TB for Detection of Tuberculosis Infection among Hematological Malignancy Patients and Hematopoietic Stem Cell Transplant Recipients

Indeterminate test results of T-SPOTTM.TB performed under routine field conditions

O desafio da tuberculose na faixa etária pediátrica frente a novas técnicas diagnósticas

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