title: Clinical utility of the QuantiFERON-TB Gold In-Tube test for the diagnosis of active pulmonary tuberculosis.
abstract: 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.
authors.affiliation: Division of Pulmonary and Critical Care Medicine, Samsung Medical Centre, Department of Medicine, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
authors.forename: So Young
authors.initials: SY
authors.lastname: Park
authors.forename: Kyeongman
authors.initials: K
authors.lastname: Jeon
authors.forename: Sang-Won
authors.initials: SW
authors.lastname: Um
authors.forename: O Jung
authors.initials: OJ
authors.lastname: Kwon
authors.forename: Eun-Suk
authors.initials: ES
authors.lastname: Kang
authors.forename: Won-Jung
authors.initials: WJ
authors.lastname: Koh
mesh_terms: 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*
chemical_list: D011933:Reagent Kits, Diagnostic; D007371:Interferon-gamma