Journal Article

Prospective Comparison of the Tuberculin Skin Test and 2 Whole-Blood Interferon-γ Release Assays in Persons with Suspected Tuberculosis

Gerald H. Mazurek, Stephen E. Weis, Patrick K. Moonan, Charles L. Daley, John Bernardo, Alfred A. Lardizabal, Randall R. Reves, Sean R. Toney, Laura J. Daniels and Philip A. LoBue

in Clinical Infectious Diseases

Published on behalf of Infectious Diseases Society of America

Volume 45, issue 7, pages 837-845
Published in print October 2007 | ISSN: 1058-4838
Published online October 2007 | e-ISSN: 1537-6591 | DOI: http://dx.doi.org/10.1086/521107
Prospective Comparison of the Tuberculin Skin Test and 2 Whole-Blood Interferon-γ Release Assays in Persons with Suspected Tuberculosis

More Like This

Show all results sharing these subjects:

  • Infectious Diseases
  • Immunology
  • Public Health and Epidemiology
  • Microbiology

GO

Show Summary Details

Preview

Background. Interferon-γ release assays (IGRAs) are attractive alternatives to the tuberculin skin test (TST) for detecting Mycobacterium tuberculosis infection. However, the inability to definitively confirm the presence of most M. tuberculosis infections hampers assessment of IGRA accuracy. Although IGRAs are primarily indicated for the detection of latent tuberculosis infection, we sought to determine the sensitivity of the TST and 2 whole-blood IGRAs (QuantiFERON-TB assay [QFT] and QuantiFERON-TB Gold assay [QFT-G]) in situations in which infection is confirmed by recovery of M. tuberculosis by culture.

Methods. We conducted a prospective, multicenter, cross-sectional comparison study in which 148 persons suspected to have tuberculosis were tested simultaneously with the TST, QFT, and QFT-G.

Results. M. tuberculosis was cultured from samples from 69 (47%) of 148 persons suspected to have tuberculosis; the TST induration was ⩾5 mm for 51 (73.9%) of the 69 subjects (95% confidence interval [CI], 62.5%–82.8%). The QFT indicated tuberculosis infection for 48 (69.6%) of the 69 subjects (95% CI, 57.9%–79.2%) and was indeterminate for 7 (10.1%). The QFT-G yielded positive results for 46 (66.7%) of the 69 subjects (95% CI, 54.9%–76.7%) and indeterminate results for 9 subjects (13.0%). If subjects with indeterminate QFT-G results were excluded, 46 (76.7%) of 60 subjects (95% CI, 64.6%–85.6%) had positive TST results, and the same number of subjects had positive QFT-G results. HIV infection was associated with false-negative TST results but not with false-negative QFT-G results.

Conclusions. The TST, QFT, and QFT-G have similar sensitivity in persons with culture-confirmed infection. As with the TST, negative QFT and QFT-G results should not be used to exclude the diagnosis of tuberculosis in persons with suggestive signs or symptoms.

Journal Article.  4546 words.  Illustrated.

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

Full text: subscription required

How to subscribe Recommend to my Librarian

Users without a subscription are not able to see the full content. Please, subscribe or login to access all content.