title: Use of the QuantiFERON-TB Gold In-Tube Test in the Diagnosis and Monitoring of Treatment Efficacy in Active Pulmonary Tuberculosis.
abstract: The value of QuantiFERON in the diagnosis of tuberculosis disease and in the monitoring of the response to anti-tuberculosis treatment is unclear. The aims of this study were to evaluate the accuracy of the QuantiFERON-TB Gold In-Tube (QFT-GIT) test in the diagnosis of tuberculosis and in the monitoring of the response to anti-tuberculosis treatment in patients with active pulmonary tuberculosis (PTB). Between January 2013 and December 2015, 133 cases with active PTB and 133 controls with no mycobacterial infection, matched by age (within 3 years) and by the week that they visited Tainan Chest Hospital, were enrolled in the study. Serial testing by QFT-GIT at baseline and after 2 and 6 months of treatment was performed. At these time points, a comparison of the performance of QFT-GIT with that of sputum culture status among study subjects was conducted. Compared to baseline, 116 (87.2%) cases showed a decreased response, whereas 17 (12.8%) showed persistent or stronger interferon-gamma (IFN-γ) responses at 2 months. PTB patients IFN-γ responses declined significantly from baseline to 2 months (median, 6.32 vs. 4.12;p< 0.005). The sensitivity values of the QFT-GIT test for the detection of pulmonary tuberculosis at cut-off points of 0.35 IU/mL, 0.20 IU/mL, and 0.10 IU/mL were 74.4%, 78.2%, and 80.5%, respectively. The specificity values at cut-off points of 0.35 IU/mL, 0.20 IU/mL, and 0.10 IU/mL were 66.2%, 63.9%, and 57.1%, respectively. Our results support the QFT-GIT assay as a potential tool for diagnosing tuberculosis and for monitoring the efficacy of anti-tuberculosis treatment.
authors.affiliation: Division of Infectious Diseases, Department of Internal Medicine, Chi-Mei Medical Center, Liouying, Tainan 736, Taiwan. 2LH101@TMH.org.tw.
authors.forename: Ping-Chin
authors.initials: PC
authors.lastname: Chang
authors.affiliation: Department of Public Health, College of Medicine, National Cheng Kung University, Tainan 701, Taiwan. e8755013@yahoo.com.tw.
authors.forename: Pin-Hui
authors.initials: PH
authors.lastname: Wang
authors.affiliation: Department of Public Health, College of Medicine, National Cheng Kung University, Tainan 701, Taiwan. ktchen@mail.ncku.edu.tw.|Department of Occupational Medicine, Tainan Municipal Hospital, Tainan 701, Taiwan. ktchen@mail.ncku.edu.tw.
authors.forename: Kow-Tong
authors.initials: KT
authors.lastname: Chen
mesh_terms: D000368:Aged; D000995:Antitubercular Agents / Q000627:therapeutic use; D001681:Biological Assay; D005260:Female; D006046:Gold; D006801:Humans; D007371:Interferon-gamma / Q000378:metabolism*; D008297:Male; D008875:Middle Aged; D011933:Reagent Kits, Diagnostic; D012680:Sensitivity and Specificity; D013183:Sputum / Q000378:metabolism*; D016896:Treatment Outcome; D014397:Tuberculosis, Pulmonary / Q000175:diagnosis* / Q000188:drug therapy / Q000378:metabolism
chemical_list: D000995:Antitubercular Agents; D011933:Reagent Kits, Diagnostic; D006046:Gold; D007371:Interferon-gamma
keywords: QuantiFERON-TB Gold In-Tube test; pulmonary tuberculosis; sensitivity; specificity