Diagnosis of tuberculosis infection by tuberculin skin test and a whole-blood interferon-γ release assay in patients considered for anti–tumor necrosis factor-α therapy

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• 作者：Susana Casas^a ; ^b ; Ana Andreu^c ; Xavier Juanola^d ; Xavier Bordas^e ; ^b ; Fernando Alcaide^c ; ^b ; ^f ; Raquel Moure^c ; Luis Anibarro^g ; Eva Cuch&#xed ; ^h ; Maria Esteveⁱ ; Vera Ortiz^j ; Maria Rosario Guerra^a ; Jesus Rodr&#xed ; guez^d ; Delia Reina^d ; Georgina Salvador^k ; Jordi Guardiola^l ; Xavier Sur&#xed ; s^j ; Maria Angeles Pascual^m ; Carmina Mart&#xed ; ⁿ ; Xavier Mart&#xed ; nez-Lacasa^o ; Jordi Cuquet^p ; Lucia Gonzalez^a ; Miguel Santin^a ; ^b ; ^f ; ^{msantin@bellvitgehospital.cat"" rel=""nofollow}
• 关键词：Anti-TNF-α ; Chronic inflammatory diseases ; Interferon-γ ; Tuberculosis ; Interferon gamma release assays (IGRA)
• 刊名：Diagnostic Microbiology and Infectious Disease
• 出版年：2011
• 出版时间：September 2011
• 年：2011
• 卷：71
• 期：1
• 页码：57-65
• 全文大小：622 K

文摘

To assess the performance of QuantiFERON®-TB Gold in-Tube (QFT-GIT; Cellestis, Carnegie, Australia) and tuberculin skin test (TST) in patients with immune-mediated inflammatory diseases (IMID), before anti–tumor necrosis factor-α (TNF-α) therapy, and to compare the results with those from the healthy population. Three hundred fourteen subjects (214 with IMID and 100 controls) underwent simultaneous QFT-GIT and TST. QFT-GIT was positive in 21 % of IMID patients and in 16 % of controls (P = 0.29). Among IMID patients, 21 % tested positive by QFT-GIT and 24 % , by TST (P = 0.30). Positive QFT-GIT results were not affected by immunosuppressive therapy (odds ratio, 0.78; 95 % confidence interval [CI], 0.36–1.68; P = 0.52). Agreement between both tests in those patients who tested positive by one of the tests was 50 % (95 % CI, 37.2–62.8). QFT-GIT is useful for identifying IMID patients requiring treatment of latent tuberculosis before anti-TNF therapy. However, given the poor agreement between TST and QFT-GIT, we advocate a strategy of simultaneous testing to optimize diagnostic sensitivity.