Clinical evaluation for diagnosing active TB disease and transitional change of two commercial blood tests.
We compared the usefulness of TST, QFT-TB and T-SPOT.TB for the identification of patients with active tuberculosis (TB) disease and investigated transitional change in both tests during anti-tuberculous treatment. The subjects were 50 healthy volunteers and 48 patients with active TB disease between October 2005 and December 2006. Among active TB disease patients, 60% had a positive TST result, 81% had a positive QFT-TB result, and 87% had a positive T-SPOT.TB result. Indeterminate results of QFT-TB and T-SPOT.TB were recognized in 12% and 6% of patients, respectively. Negative results on QFT-TB and T-SPOT.TB were 6% each. QFT-TB had a sensitivity of 81% for active TB disease. T-SPOT.TB had a sensitivity of 88% for active TB disease. With regard to transitional changes in QFT-TB results and T-SPOT.TB results, both test results showed a positive response in over 40% of patients 12 months after anti-tuberculous treatment. In conclusion, both blood assays seemed to be more useful than TST for the identification of patients with active TB disease. However, neither of the 2 blood tests appears to provide any certainty regarding the cure of infection.
Kobashi
Yoshihiro
Y
Division of Respiratory Diseases, Department of Medicine, Kawasaki Medical School, Matsushima, Kurashiki, Japan. yoshihiro@med.kawasaki-m.ac.jp
Mouri
Keiji
K
Yagi
Shinichi
S
Obase
Yasushi
Y
Miyashita
Naoyuki
N
Okimoto
Niro
N
Matsushima
Toshiharu
T
Kageoka
Takeshi
T
Oka
Mikio
M
D000368:Aged; D000942:Antigens, Bacterial / Q000276:immunology; D000995:Antitubercular Agents / Q000627:therapeutic use; D001500:BCG Vaccine; D001426:Bacterial Proteins / Q000276:immunology; D016009:Chi-Square Distribution; D004797:Enzyme-Linked Immunosorbent Assay / Q000379:methods; D005260:Female; D006801:Humans; D007371:Interferon-gamma / Q000032:analysis; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009169:Mycobacterium tuberculosis / Q000276:immunology; D014374:Tuberculin Test; D014376:Tuberculosis / Q000097:blood / Q000175:diagnosis* / Q000188:drug therapy
D000942:Antigens, Bacterial; D000995:Antitubercular Agents; D001500:BCG Vaccine; D001426:Bacterial Proteins; C117940:CFP-10 protein, Mycobacterium tuberculosis; C093276:ESAT-6 protein, Mycobacterium tuberculosis; D007371:Interferon-gamma