title: Poor agreement between QuantiFERON-TB Gold test and tuberculin skin test results for the diagnosis of latent tuberculosis infection in rheumatoid arthritis patients and healthy controls.
abstract: OBJECTIVE
  We investigated the agreement between the QuantiFERON-TB Gold (QFT-Gold) test and the tuberculin skin test (TST) in the diagnosis of latent tuberculosis infection in patients with rheumatoid arthritis (RA), compared with healthy controls, in Korea.
  
  
  METHODS
  We recruited 64 patients with RA and 79 healthy controls at two university hospitals in South Korea. The participants underwent both the QFT-Gold test and the TST simultaneously between August 2006 and February 2009. All patients were diagnosed using the classification criteria for RA revised in 1987 by the American College of Rheumatology. Bacillus Calmette-Guérin vaccination status and current medications were evaluated, and disease activities were assessed using the Disease Activity Score in 28 joints. Eleven patients with RA produced indeterminate QFT-Gold test results and were thus excluded from the kappa analysis.
  
  
  RESULTS
  Based on an induration of 10 mm in diameter as the TST cutoff value, the QFT-Gold test and TST demonstrated 75.0% agreement (κ = 0.23) in patients with RA and 75.9% agreement (κ = 0.19) in healthy controls. Among the 56 patients with RA who had negative TST results, 11 patients (17.2%) also yielded indeterminate QFT-Gold results.
  
  
  CONCLUSIONS
  Our study showed poor agreement between the results of the QFT-Gold test and the TST in both RA patients and healthy controls. Based on these findings, we emphasize the importance of making clinical decisions in the diagnosis of latent tuberculosis in Koreans with or without RA.
authors.affiliation: Department of Internal Medicine, Inje University Ilsan Paik Hospital, Goyang, Korea.
authors.forename: Joo-Hyun
authors.initials: JH
authors.lastname: Lee
authors.affiliation: Department of Preventive Medicine, Inje University College of Medicine, Busan, Korea.
authors.forename: Hae Sook
authors.initials: HS
authors.lastname: Sohn
authors.affiliation: Department of Preventive Medicine, Inje University College of Medicine, Busan, Korea.
authors.forename: Jin Ho
authors.initials: JH
authors.lastname: Chun
authors.affiliation: Department of Rheumatology, Ajou University School of Medicine, Suwon, Korea.
authors.forename: Hyoun-Ah
authors.initials: HA
authors.lastname: Kim
authors.affiliation: Department of Rheumatology, Ajou University School of Medicine, Suwon, Korea.
authors.forename: Chang Hee
authors.initials: CH
authors.lastname: Suh
authors.affiliation: Withus Medical Clinic, Goyang, Korea.
authors.forename: Yun Woo
authors.initials: YW
authors.lastname: Lee
authors.affiliation: Department of Internal Medicine, Inje University Ilsan Paik Hospital, Goyang, Korea.
authors.forename: Bo Young
authors.initials: BY
authors.lastname: Yoon
mesh_terms: D000328:Adult; D000368:Aged; D001172:Arthritis, Rheumatoid / Q000150:complications*; D005260:Female; D064368:Healthy Volunteers; D006801:Humans; D059425:Interferon-gamma Release Tests / Q000706:statistics & numerical data*; D055985:Latent Tuberculosis / Q000150:complications / Q000175:diagnosis*; D008297:Male; D008875:Middle Aged; D014374:Tuberculin Test / Q000706:statistics & numerical data*
keywords: Arthritis, rheumatoid; Latent tuberculosis; QuantiFERON-TB Gold test; Tuberculin skin test