title: Comparison of the QuantiFERON-TB Gold In-Tube test with the tuberculin skin test for detecting latent tuberculosis infection in hemodialysis patients.
abstract: OBJECTIVE
  Hemodialysis (HD) patients are at increased risk of reactivation of latent tuberculosis (TB) infection (LTBI). LTBI screening of this population is recommended. The QuantiFERON-TB Gold assay (QFT-G) may be more accurate than the tuberculin skin test (TST) in the detection of LTBI. We prospectively compared the results of QFT-G to TST in HD patients.
  
  
  METHODS
  We examined 100 patients and performed TST and QFT-G tests. Data obtained from patients and medical records included medical history (past history of TB, Bacillus Calmette-Guerin [BCG] vaccination, history of contact with previous TB cases), radiography reports (chest x-ray with changes consistent with old TB), and basic laboratory findings.
  
  
  RESULTS
  Forty-three of 100 patients (43%) had a positive QFT-G test result and 34 (34%) had a positive TST test result. Overall agreement between the QFT-G and the TST was 65% (concordance [k]=0.26, P=0.01). Discordant test results were seen in 13 TST-positive/QFT-G-negative patients and in 22 TST-negative/QFT-G-positive patients. Before BCG vaccination and radiographic reports (of old TB changes) were associated with discordant test results. On multivariate analysis, a positive QFT-G test was associated with contact with previous TB cases (P=0.026) and radiographic report (P=0.034), whereas a positive TST test also was associated with a history of BCG vaccination (P=0.015).
  
  
  CONCLUSIONS
  QFT-G test results were more closely associated with TB risk factors than were positive TST results. Additionally, the QFT-G test was not affected by BCG vaccination. We concluded that QFT-G test is a more useful diagnostic method than TST for detecting LTBI in HD patients.
authors.affiliation: Department of Chest Diseases, Yedikule Chest Diseases and Thoracic Surgery Education and Research Hospital, Istanbul, Turkey. drekremcs@yahoo.com
authors.forename: E C
authors.initials: EC
authors.lastname: Seyhan
authors.forename: S
authors.initials: S
authors.lastname: Sökücü
authors.forename: S
authors.initials: S
authors.lastname: Altin
authors.forename: G
authors.initials: G
authors.lastname: Günlüoğlu
authors.forename: S
authors.initials: S
authors.lastname: Trablus
authors.forename: D
authors.initials: D
authors.lastname: Yilmaz
authors.forename: O K
authors.initials: OK
authors.lastname: Koksalan
authors.forename: H
authors.initials: H
authors.lastname: Issever
mesh_terms: D001426:Bacterial Proteins / Q000276:immunology; D001431:Bacteriological Techniques / Q000379:methods*; D016022:Case-Control Studies; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006801:Humans; D007371:Interferon-gamma / Q000378:metabolism; D055985:Latent Tuberculosis / Q000097:blood / Q000150:complications / Q000175:diagnosis*; D008297:Male; D008875:Middle Aged; D009169:Mycobacterium tuberculosis / Q000276:immunology*; D009842:Oligopeptides; D011446:Prospective Studies; D011994:Recombinant Proteins / Q000276:immunology; D006435:Renal Dialysis / Q000009:adverse effects*; D051437:Renal Insufficiency / Q000150:complications / Q000601:surgery; D012680:Sensitivity and Specificity; D014374:Tuberculin Test; D014421:Turkey
chemical_list: D001426:Bacterial Proteins; D009842:Oligopeptides; D011994:Recombinant Proteins; D007371:Interferon-gamma