Journal Article

Comparing Interferon-γ Release Assay with Tuberculin Skin Test Readings at 48–72 Hours and 144–168 Hours with Use of 2 Commercial Reagents

David Tat, Hari Polenakovik and Thomas Herchline

in Clinical Infectious Diseases

Published on behalf of Infectious Diseases Society of America

Volume 40, issue 2, pages 246-250
Published in print January 2005 | ISSN: 1058-4838
Published online January 2005 | e-ISSN: 1537-6591 | DOI: http://dx.doi.org/10.1086/426816
Comparing Interferon-γ Release Assay with Tuberculin Skin Test Readings at 48–72 Hours and 144–168 Hours with Use of 2 Commercial Reagents

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Background. Despite widespread use, the tuberculin skin test (TST) has many limitations, including a requirement for a second visit between 48 and 72 hours. The goal of this study was to determine the reliability of a TST reading between 144 and 168 hours.

Methods. Tuberculin antigen was applied into both forearms (Aplisol in one arm and Tubersol in the other, from single lots of each product) by the Mantoux method. Blood samples were obtained for interferon-γ release assay. Subjects were seen at 48–72 hours for the initial (day 2) TST reading and returned at 144–168 hours for a second (day 7) reading.

Results. A total of 116 subjects at increased risk for tuberculosis were studied; 25 (22%) had positive results at day 2 with Tubersol and 27 (23%) had positive results at day 2 with Aplisol. Overall agreement between Tubersol and Aplisol at day 2 was 93% (κ = 0.80) and at day 7 was 94% (κ = 0.76). Overall agreement between day 2 and day 7 was 89% for Tubersol and 86% for Aplisol. Discordant results between day 2 and day 7 occurred mostly in persons with a history of bacille Calmette-Guérin vaccination.

Conclusions. Subjects who fail to present at 48–72 hours for TST reading may still have a reliable TST reading at up to 168 hours. Aplisol and Tubersol reagents produce comparable results when compared with the interferon-γ release assay.

Journal Article.  3508 words.  Illustrated.

Subjects: Infectious Diseases ; Immunology ; Public Health and Epidemiology ; Microbiology

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