Usefulness of Interferon-Gamma Release Assays in the Diagnosis of Tuberculosis Infection in HIV-Infected Patients in Bulgaria

Markova, Roumiana; Todorova, Yana; Drenska, Roumiana; Elenkov, Ivaylo; Yankova, M.; Stefanova, Denitsa

doi:10.1080/13102818.2009.10817622

Cited by 17 publications

(22 citation statements)

References 28 publications

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“…However, data on conversions, reversions, and predictive value of QFT in such programs for health care workers (HCWs) are limited, (45) although there were no statistical significant differences between the studied groups regarding Quantiferon TB gold test. The Evaluation of QFT-Gold IT test as a diagnostic tool for TB in relation to culture in active TB groups (I, II) showed high sensitivity(91.18% ) and high specificity(83.33%), similar to other studies (40,46,47) that reported QFT-Gold IT test sensitivity from 88% to 93% and specificity from 90% to 98%.The explanation of this higher observed sensitivity could be due to the characteristics of the participants, who were mostly young. As IGRA sensitivity has been reported to decrease significantly with older age (48) , HIV infection (49) , and chronic renal failure (50) .…”

Section: Discussionsupporting

confidence: 86%

Interferon Gamma Release Assays (IGRA) in the Diagnosis of Active Pulmonary Tuberculosis

Eldeeb

Malwany

Khalil

et al. 2014

Journal of High Institute of Public Health

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Background: Tuberculosis is one of the deadliest diseases over the world. Diagnosis of pulmonary TB depends on combination various parameters. IGRA measure T cell release of IFN-γ in response to M.TB antigen. WHO policy statement as on IGRA use in low and middle income countries is not established yet. Objective: The present study aimed to compare between tuberculin skin test (TST) and interferon gamma release assay (IGRA) in the diagnosis of active tuberculosis infection and study the effect of 3 months of first line anti-TB therapy on the positivity of the IGRA test. Methods: 40 Egyptian patients were included in the study, and assigned as two groups; Group I comprised 20 patients with negative sputum for AFB by Ziehl-Neelsen stains with positive sputum culture for M.TB and Group II included 20 patients with positive sputum and Ziehl-Neelsen for AFB before and after 3 months of first line of anti-TB therapy. All patients were subjected to full history taking, clinical examination, X-ray chest, lab investigations, ESR measurements, microbiological tests and ELISA measurement of Quantiferon-TB Gold. Results: Lower significant values were found in group II after treatment than before treatment regarding clinical parameters and 1 st and 2 nd hours ESR. IGRA test and TST showed sensitivity (91.18%, 76.4%), specificity (83.33%, 66.67%), positive predictive value (96.88%, 92.86%), negative predictive value (62.5%, 33.3%) and accuracy of (90%, 75%) respectively. IGRA results had no statistical significant differences between the studied groups with poor agreement with TST ((κ) = 0.025). Conclusion: IGRAS test had high sensitivity and specificity in diagnosis of active TB. More studies are needed to evaluate the effect of anti-TB therapy on IGRA level.

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Section: Discussionsupporting

confidence: 86%

Interferon Gamma Release Assays (IGRA) in the Diagnosis of Active Pulmonary Tuberculosis

Eldeeb

Malwany

Khalil

et al. 2014

Journal of High Institute of Public Health

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“…In nine of these, TST positivity was significantly associated with BCG vaccination as an independent predictor in multivariate analysis [47,50,55,62,67,71,72,74,77] with odd ratios ranging between 3.8 (95% CI 1.0-13.9) [50] [35] GOLETTI [36] JAFARI [37] JAFARI [38] KAMPMANN [39] KANG [40] LEE [41] MARKOVA [42] WANG [43] DETJEN [26] DHEDA [34] GOLETTI [36] KAMPMANN [39] KANG [40] MARKOVA [42] odds for test positivity with M. tuberculosis exposure gradients, or using chest radiography lesions as a surrogate of prior exposure, the IGRAs associated better with exposure than the TST, irrespective of the setting's disease burden. Furthermore, there was generally a poor agreement between IGRAs and TST results (for k statistics, see table 3).…”

Section: Ppv For Progressionmentioning

confidence: 99%

“…NPV in patients with active tuberculosis 18 articles satisfied our inclusion criteria for evaluating the NPV; 13 assessed the NPV among confirmed tuberculosis cases [22,26,[34][35][36][37][38][39][40][41][42][43][44] and six assessed the prospective outcome in IGRA-negative individuals after an average of 2 yrs [19-22, 45, 46]. Among the studies in which the NPV was evaluated in patients with confirmed tuberculosis (387 tuberculosis cases with a valid T-SPOT1.TB result and 304 with valid QFT-G-IT result), the NPV varied greatly, irrespective of the IGRA used.…”

Section: Specificitymentioning

confidence: 99%

Interferon- release assays for the diagnosis of latent Mycobacterium tuberculosis infection: a systematic review and meta-analysis

Diel¹,

Goletti²,

Ferrara³

et al. 2010

European Respiratory Journal

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487

315

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We conducted a systematic review and meta-analysis to compare the accuracy of the QuantiFERON-TB1 Gold In-Tube (QFT-G-IT) and the T-SPOT1.TB assays with the tuberculin skin test (TST) for the diagnosis of latent Mycobacterium tuberculosis infection (LTBI).The Medline, Embase and Cochrane databases were explored for relevant articles in November 2009. Specificities, and negative (NPV) and positive (PPV) predictive values of interferon-c release assays (IGRAs) and the TST, and the exposure gradient influences on test results among bacille Calmette-Guérin (BCG) vaccinees were evaluated.Specificity of IGRAs varied 98-100%. In immunocompetent adults, NPV for progression to tuberculosis within 2 yrs were 97.8% for T-SPOT1.TB and 99.8% for QFT-G-IT. When test performance of an immunodiagnostic test was not restricted to prior positivity of another test, progression rates to tuberculosis among IGRA-positive individuals followed for 19-24 months varied 8-15%, exceeding those reported for the TST (2-3%). In multivariate analyses, the odd ratios for TST positivity following BCG vaccination varied 3-25, whereas IGRA results remained uninfluenced and IGRA positivity was clearly associated with exposure to contagious tuberculosis cases.IGRAs may have a relative advantage over the TST in detecting LTBI and allow the exclusion of M. tuberculosis infection with higher reliability.

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“…Pooled sensitivity of QFT-GIT was 60% (CI, 34 to 82%). T-SPOT.TB seemed slightly less affected by immunosuppression, with a pooled sensitivity of 76% (CI, 45% to 92%) [18], but only five studies compared their sensitivity head to head [93, 107–110], with only one study showing QFT-GIT with a greater sensitivity than T-SPOT.TB in PLWHA [110]. Likewise, 14 studies have analyzed the role of IGRA in patients with autoimmune disease [111–124], 10 of them in countries where BCG vaccination is not routinely done [111–113, 116–118, 120, 121, 123, 124].…”

Section: Ltbi In Special Populationsmentioning

confidence: 99%

Interferon-Gamma Release Assays versus Tuberculin Skin Testing for the Diagnosis of Latent Tuberculosis Infection: An Overview of the Evidence

2013

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A profusion of articles have been published on the accuracy and uses of interferon-gamma releasing assays. Here we review the clinical applications, advantages, and limitations of the tuberculin skin test and interferon-gamma release assays and provide an overview of the most recent systematic reviews conducted for different indications for the use of these tests. We conclude that both tests are accurate to detect latent tuberculosis, although interferon-gamma release assays have higher specificity than tuberculin skin testing in BCG-vaccinated populations, particularly if BCG is received after infancy. However, both tests perform poorly to predict risk for progression to active tuberculosis. Interferon-gamma release assays have significant limitations in serial testing because of spontaneous variability and lack of a validated definition of conversion and reversion, making it difficult for clinicians to interpret changes in category (conversions and reversions). So far, the most important clinical evidence, that is, that isoniazid preventive therapy reduces the risk for progression to disease, has been produced only in tuberculin skin test-positive individuals.

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Usefulness of Interferon-Gamma Release Assays in the Diagnosis of Tuberculosis Infection in HIV-Infected Patients in Bulgaria

Cited by 17 publications

References 28 publications

Interferon Gamma Release Assays (IGRA) in the Diagnosis of Active Pulmonary Tuberculosis

Interferon Gamma Release Assays (IGRA) in the Diagnosis of Active Pulmonary Tuberculosis

Interferon- release assays for the diagnosis of latent Mycobacterium tuberculosis infection: a systematic review and meta-analysis

Interferon-Gamma Release Assays versus Tuberculin Skin Testing for the Diagnosis of Latent Tuberculosis Infection: An Overview of the Evidence

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