title: Interferon-gamma-release assay prevents unnecessary tuberculosis therapy.
abstract: BACKGROUND
  The mass influx of immigrants from tuberculosis-endemic countries into Israel was followed by a considerable increase in the incidence of tuberculosis (TB). All contacts of active TB patients are obliged to be screened by tuberculin skin tests (TST) and, if found positive, prophylactic treatment is considered.
  
  
  OBJECTIVE
  To assess the utility of interferon-gamma (IFNγ)-release assay with a prolonged follow-up in preventing unnecessary anti-TB therapy in individuals with suspected false positive results.
  
  
  METHODS
  Between 2008 and 2012 the QuantiFERON TB gold-in-tube test (QFT-G) was performed in 278 sequential individuals who were mostly TST-positive and/or were in contact with an active TB patient. In all, whole blood was examined by the IFNγ-release assay. We correlated the TST diameter with the QFT-G assay and followed those patients with a negative assay.
  
  
  RESULTS
  The QFT-G test was positive in only 72 (42%) of all 171 TST-positive individuals. There was no correlation between the diameter of TST and QFT-G positivity. Follow-up over 5 years was available in 128 (62%) of all QFT-G-negative individuals. All remained well and none developed active TB.
  
  
  CONCLUSIONS
  A negative QFT-G test may obviate the need for anti-TB therapy in more than half of those with a positive TST.
authors.forename: Vered
authors.initials: V
authors.lastname: Schichter-Konfino
authors.forename: Katalin
authors.initials: K
authors.lastname: Halasz
authors.forename: Galia
authors.initials: G
authors.lastname: Grushko
authors.forename: Ayelet
authors.initials: A
authors.lastname: Snir
authors.forename: Tharwat
authors.initials: T
authors.lastname: Haj
authors.forename: Zahava
authors.initials: Z
authors.lastname: Vadasz
authors.forename: Aharon
authors.initials: A
authors.lastname: Kessel
authors.forename: Israel
authors.initials: I
authors.lastname: Potasman
authors.forename: Elias
authors.initials: E
authors.lastname: Toubi
mesh_terms: D000995:Antitubercular Agents / Q000627:therapeutic use*; D004358:Drug Therapy / Q000706:statistics & numerical data*; D054242:Emigrants and Immigrants / Q000706:statistics & numerical data; D005189:False Positive Reactions; D005260:Female; D006801:Humans; D015994:Incidence; D059425:Interferon-gamma Release Tests / Q000379:methods / Q000706:statistics & numerical data; D007557:Israel / Q000453:epidemiology; D008297:Male; D008403:Mass Screening / Q000379:methods; D014374:Tuberculin Test / Q000379:methods; D014376:Tuberculosis / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy; D019564:Unnecessary Procedures
chemical_list: D000995:Antitubercular Agents