Kinetics of the QuantiFERON-TB Gold In-Tube test during treatment of patients with sputum smear-positive tuberculosis in relation to initial TST result and severity of disease.
The QuantiFERON-TB Gold In-Tube test (QFN) measures interferon-gamma production in response to Mycobacterium tuberculosis antigens. Our aim was to assess the kinetics of the QFN and initial tuberculin skin test (TST) result in relation to severity of disease in a tuberculosis (TB) endemic area. Smear-positive TB patients (n = 71) were recruited at Gondar University Hospital, Ethiopia. The TST, QFN, CD4+ cell count and clinical symptoms (TB score) were assessed and followed up during treatment. From baseline to 7 months after treatment, there was a significant decrease in QFN reactivity (93.8% to 62.5% in HIV-negative/TB; 70.3% to 33.3% in HIV-positive/TB patients) down to a level comparable to a control group of blood donors (51.2%). The agreement between TST and QFN was poor in TB patients compared to healthy controls. A negative TST correlated to more advanced TB in contrast to a negative QFN test. We conclude that the QFN reactivity is significantly reduced at the end of treatment against active TB to the background level of healthy blood donors, and that the agreement between TST and QFN is poor including correlation to the severity of disease.
Idh
Jonna
J
Department of Medical Microbiology, Faculty of Health Sciences, Linköping University, Linköping, Sweden. jonna.idh@liu.se
Abate
Ebba
E
Westman
Anna
A
Elias
Daniel
D
Janols
Helena
H
Gelaw
Aschalew
A
Getachew
Assefa
A
Alemu
Shitaye
S
Aseffa
Abraham
A
Britton
Sven
S
Stendahl
Olle
O
Schön
Thomas
T
D000293:Adolescent; D000328:Adult; D000995:Antitubercular Agents / Q000627:therapeutic use*; D001782:Blood Donors; D018791:CD4 Lymphocyte Count; D016009:Chi-Square Distribution; D004797:Enzyme-Linked Immunosorbent Assay / Q000379:methods*; D005260:Female; D015658:HIV Infections / Q000378:metabolism; D006801:Humans; D007371:Interferon-gamma / Q000032:analysis / Q000096:biosynthesis; D007700:Kinetics; D008297:Male; D008875:Middle Aged; D009169:Mycobacterium tuberculosis; D011237:Predictive Value of Tests; D014374:Tuberculin Test / Q000379:methods*; D014376:Tuberculosis / Q000175:diagnosis* / Q000188:drug therapy* / Q000821:virology
D000995:Antitubercular Agents; D007371:Interferon-gamma