Clinical utility of the QuantiFERON-TB Gold In-Tube test for the diagnosis of active pulmonary tuberculosis.
We evaluated the usefulness of interferon-gamma release assays (IGRAs) in the diagnosis of active tuberculosis (TB) in routine clinical practice. We retrospectively assessed the diagnostic usefulness of the QuantiFERON-TB Gold In-Tube (QFT-IT) test in 519 consecutive patients who were suspected of having active pulmonary TB and had QFT-IT test results. Active pulmonary TB was diagnosed in 242 patients (47%). The sensitivity in the diagnosis of active pulmonary TB was higher with the QFT-IT test (84%) than with the tuberculin skin test (TST; 74%; p=0.003). The negative predictive value in the diagnosis of active pulmonary TB was also higher with the QFT-IT test (79%) than with the TST (70%; p=0.023). Among 59 patients with non-tuberculous mycobacterial lung disease, the QFT-IT test was positive in 29 patients (49%). In conclusion, the high negative predictive value of the QFT-IT suggests a supplementary role for this test in the diagnostic exclusion of active TB. However, negative QFT-IT test results should not be used alone to exclude active TB. Additionally, the QFT-IT test has limited usefulness in differentiating active pulmonary TB from non-tuberculous mycobacterial lung disease in areas with a high prevalence of latent tuberculosis infection.
Park
So Young
SY
Division of Pulmonary and Critical Care Medicine, Samsung Medical Centre, Department of Medicine, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
Jeon
Kyeongman
K
Um
Sang-Won
SW
Kwon
O Jung
OJ
Kang
Eun-Suk
ES
Koh
Won-Jung
WJ
D000328:Adult; D000368:Aged; D016009:Chi-Square Distribution; D003937:Diagnosis, Differential; D004797:Enzyme-Linked Immunosorbent Assay / Q000379:methods*; D005260:Female; D006801:Humans; D007371:Interferon-gamma / Q000378:metabolism*; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011933:Reagent Kits, Diagnostic; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012307:Risk Factors; D012680:Sensitivity and Specificity; D014374:Tuberculin Test; D014397:Tuberculosis, Pulmonary / Q000175:diagnosis*
D011933:Reagent Kits, Diagnostic; D007371:Interferon-gamma