title: Sensitivity of a whole-blood interferon-gamma assay among patients with pulmonary tuberculosis and variations in T-cell responses during anti-tuberculosis treatment.
abstract: BACKGROUND
  Interferon-gamma (IFN-gamma) assays are new tests for tuberculosis (TB) infection, and T-cell responses may be correlated with antigen burden. However, it is unclear if IFN-gamma assays can be used to monitor response to TB treatment.
  
  
  METHODS
  We measured T-cell responses to TB specific antigens in 60 Indian patients with microbiologically confirmed active pulmonary tuberculosis, before, during, and after TB treatment. Most patients were hospitalized and had moderate to advanced disease. IFN-gamma responses were measured using the commercial whole-blood Quanti-FERON-TB Gold In Tube (QFT-G) assay at three time-points: at diagnosis (N = 60), after 2 months of intensive treatment (N = 47), and at 6 months (treatment completion) (N = 39).
  
  
  RESULTS
  At baseline, 44 of 60 (73%) patients were positive by QFT-G. At the second time-point, 38 of 47 (81%) patients were positive. At treatment completion, 31 of 39 (79%) patients were positive. Changes in IFN-gamma responses over time were highly inconsistent--some individuals showed increases, while others showed decreases or no changes. Although the average IFN-gamma levels decreased slightly during treatment (not significant), the QFT-G sensitivity remained mostly unchanged during therapy.
  
  
  CONCLUSIONS
  Our data suggest that the QFT-G assay has modest sensitivity in patients with moderate to advanced pulmonary disease, but our results do not show a clear correlation between antigen burden and T-cell responses. Further research is needed to understand the kinetics of T-cell responses during TB treatment.
authors.affiliation: Dept. of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, QC, Canada H3A 1A2. madhukar.pai@mcgill.ca
authors.forename: M
authors.initials: M
authors.lastname: Pai
authors.forename: R
authors.initials: R
authors.lastname: Joshi
authors.forename: M
authors.initials: M
authors.lastname: Bandyopadhyay
authors.forename: P
authors.initials: P
authors.lastname: Narang
authors.forename: S
authors.initials: S
authors.lastname: Dogra
authors.forename: B
authors.initials: B
authors.lastname: Taksande
authors.forename: S
authors.initials: S
authors.lastname: Kalantri
mesh_terms: D000328:Adult; D000368:Aged; D015331:Cohort Studies; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006801:Humans; D007371:Interferon-gamma / Q000097:blood*; D008297:Male; D008875:Middle Aged; D012680:Sensitivity and Specificity; D013601:T-Lymphocytes / Q000276:immunology*; D014397:Tuberculosis, Pulmonary / Q000175:diagnosis / Q000188:drug therapy / Q000276:immunology*
chemical_list: D007371:Interferon-gamma