help button home button
AJRCCM
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH
Published ahead of print on February 14, 2008, doi:10.1164/rccm.200711-1613OC

Am. J. Respir. Crit. Care Med., Volume 177, Number 10, May 2008, 1164-1170

A more recent version of this article appeared on May 15, 2008
This Article
Right arrow Full Text (PDF)
Right arrow All Versions of this Article:
200711-1613OCv1
177/10/1164    most recent
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Right arrow reprints & permissions
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Diel, R.
Right arrow Articles by Nienhaus, A.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Diel, R.
Right arrow Articles by Nienhaus, A.

Submitted on November 1, 2007
Accepted on February 14, 2008

Predictive Value of a Whole-blood IFN-{gamma} Assay for the Development of Active TB Disease

Roland Diel1*, Robert Loddenkemper2, Karen Meywald-Walter3, Stefan Niemann4, and Albert Nienhaus5

1 School of Public Health, University of Duesseldorf, Duesseldorf, Germany, 2 Lungenklinik Heckeshorn, HELIOS Klinikum Emil von Behring, German Central Committee against Tuberculosis, Berlin, Germany, 3 Public Health Department Hamburg-Mitte, Hamburg, Germany, 4 Research Center Borstel, National Reference Center for Mycobacteria, Borstel, Germany, 5 Institution for Statutory Accident Insurance and Prevention in the Health and Welfare Services, Hamburg, Germany

* To whom correspondence should be addressed. E-mail: Roland.Diel{at}uni-duesseldorf.de.

Rationale: Numerous studies have been published on the new Mycobacterium tuberculosis (MTB) specific IFN-{gamma} release assays. However, their prognostic value for progression from latent tuberculosis infection (LTBI) to active tuberculosis (TB) has yet to be established. Objective: To compare the QuantiFERON-TB-Gold In Tube assay (QFT) with the tuberculin skin test (TST) in recently exposed close contacts of active TB cases with respect to their development of TB disease within 2 years. Methods: Close contacts, 601, of MTB-positive source cases underwent both TST and QFT testing and were subsequently observed for 103 (±13.5) weeks. Risk factors for MTB infection were evaluated by multivariate analysis. Results: For the TST, 40.4% (243/601) were positive at a 5mm cut-off, while only 66 (11%) were QFT positive. QFT positivity, but not TST, was associated with exposure time (p < 0.0001). Six contacts progressed to TB disease within the two year follow-up and all 6 were from a QFT positive group which had declined preventive treatment (n=41), equating to a progression rate of 14.6% (6/41) among those QFT positive. The progression rate for TST-positives was only 2.3% (5 of 219) and one subject who progressed was TST negative. Conclusions: Results suggest QFT screening determines more accurately than TST the presence of LTBI with at least equivalent sensitivity for predicting progression to TB. The high rate of progression to active TB of those QFT positive (14.6%), far greater than the 2.3% found for those TST positive, has significant health and economic implications for enhanced TB control.
Key words: tuberculosis; latent infection; IGRA; QuantiFERON; tuberculin skin test




This article has been cited by other articles:


Home page
 Am. J. Respir. Crit. Care Med.Home page
R. Belknap, K. Wall, and R. Reves
What Can the NHANES Data Tell Us about the Tuberculin Skin Test and the Risk for Active Tuberculosis?
Am. J. Respir. Crit. Care Med., October 15, 2008; 178(8): 883 - 884.
[Full Text] [PDF]

Home page
 Eur Respir JHome page
G. H. Bothamley, L. Ditiu, G. B. Migliori, C. Lange, and TBNET contributors
Active case finding of tuberculosis in Europe: a Tuberculosis Network European Trials Group (TBNET) survey
Eur. Respir. J., October 1, 2008; 32(4): 1023 - 1030.
[Abstract] [Full Text] [PDF]

Home page
 ANN INTERN MEDHome page
M. Pai, A. Zwerling, and D. Menzies
Systematic Review: T-Cell-based Assays for the Diagnosis of Latent Tuberculosis Infection: An Update
Ann Intern Med, August 5, 2008; 149(3): 177 - 184.
[Abstract] [Full Text] [PDF]

Home page
 Am. J. Respir. Crit. Care Med.Home page
C. C. Leung, K. C. Chang, and C. H. Chau
Is the Whole-Blood Gamma Interferon Assay Better than the Tuberculin Skin Test in Predicting Active Tuberculosis?
Am. J. Respir. Crit. Care Med., July 15, 2008; 178(2): 210 - 211.
[Full Text] [PDF]

Home page
 Am. J. Respir. Crit. Care Med.Home page
R. Diel
Is the Whole-Blood Gamma Interferon Assay Better than the Tuberculin Skin Test in Predicting Active Tuberculosis?
Am. J. Respir. Crit. Care Med., July 15, 2008; 178(2): 211 - 211.
[Full Text] [PDF]

Home page
 JWatch Infect. DiseasesHome page
IFN-{gamma} Release Assays vs. TST for Predicting Development of Active TB
Journal Watch Infectious Diseases, May 28, 2008; 2008(528): 1 - 1.
[Full Text]

Home page
 Am. J. Respir. Crit. Care Med.Home page
J. E. Stout and D. Menzies
Predicting Tuberculosis: Does the IGRA Tell the Tale?
Am. J. Respir. Crit. Care Med., May 15, 2008; 177(10): 1055 - 1057.
[Full Text] [PDF]


HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH
Proc. Am. Thorac. Soc. Am. J. Respir. Cell Mol. Biol.
Copyright © 2008 American Thoracic Society 		  ATS Best of the Web