Comparison of a whole-blood interferon-γ assay and tuberculin skin testing in patients with active tuberculosis and individuals at high or low risk of Mycobacterium tuberculosis infection

Anna Fietta, Federica Meloni, Alessandro Cascina, Monica Morosini, Carlo Marena, Panaiota Troupioti, Patrizia Mangiarotti, Lucio Casali

Research output: Contribution to journalArticle

Abstract

Background: QuantiFeron-TB (QIFN) is a whole-blood interferon-γ assay for the recognition of cell-mediated immune response to Mycobacterium tuberculosis infection. Objectives: To compare the QIFN assay with the tuberculin skin test (TST) in patients with newly diagnosed culture-proven tuberculosis (TB) and healthy volunteers with high or low risk of latent M tuberculosis infection and to identify factors associated with discordance between tests. Method: Two-hundred fifty-eight subjects underwent both assays. All participants completed a detailed questionnaire, and data from TB patients' medical records were collected. Results: In the entire study population, agreement between tests was moderate and the correlation between the magnitude of QIFN response and the TST induration diameter was significant. In volunteers with no known risk of exposure to M tuberculosis, the specificity of the assays was comparable. However, in subjects with active TB or those vaccinated with bacille Calmette-Guérin, the QIFN assay detected more reactors than did the TST. In these individuals, agreement between assays was poor and no correlation or only a weak correlation was found between the diameter of TST induration and the magnitude of the interferon-γ responses. Conclusions: The sensitivity of the QIFN assay is greater than that of the TST in patients with active TB before the initiation of anti-TB chemotherapy, but its specificity is influenced more by bacille Calmette-Guérin vaccination. The QIFN assay may provide an improvement: over the current practice of the use of the TST to support diagnosis of active M tuberculosis infection in the clinic; however, QIFN cannot be considered an adequate replacement for the TST in the screening for latent infection.

Original languageEnglish
Pages (from-to)347-353
Number of pages7
JournalAJIC: American Journal of Infection Control
Volume31
Issue number6
DOIs
Publication statusPublished - Oct 2003

Fingerprint

Mycobacterium Infections
Tuberculin
Tuberculin Test
Mycobacterium tuberculosis
Interferons
Skin Tests
Tuberculosis
Skin
Latent Tuberculosis
Infection
Medical Records
Volunteers
Healthy Volunteers
Vaccination
Drug Therapy

ASJC Scopus subject areas

  • Microbiology
  • Infectious Diseases

Cite this

@article{7ad4aa91eda34df486a1fe9fc36b63e2,
title = "Comparison of a whole-blood interferon-γ assay and tuberculin skin testing in patients with active tuberculosis and individuals at high or low risk of Mycobacterium tuberculosis infection",
abstract = "Background: QuantiFeron-TB (QIFN) is a whole-blood interferon-γ assay for the recognition of cell-mediated immune response to Mycobacterium tuberculosis infection. Objectives: To compare the QIFN assay with the tuberculin skin test (TST) in patients with newly diagnosed culture-proven tuberculosis (TB) and healthy volunteers with high or low risk of latent M tuberculosis infection and to identify factors associated with discordance between tests. Method: Two-hundred fifty-eight subjects underwent both assays. All participants completed a detailed questionnaire, and data from TB patients' medical records were collected. Results: In the entire study population, agreement between tests was moderate and the correlation between the magnitude of QIFN response and the TST induration diameter was significant. In volunteers with no known risk of exposure to M tuberculosis, the specificity of the assays was comparable. However, in subjects with active TB or those vaccinated with bacille Calmette-Gu{\'e}rin, the QIFN assay detected more reactors than did the TST. In these individuals, agreement between assays was poor and no correlation or only a weak correlation was found between the diameter of TST induration and the magnitude of the interferon-γ responses. Conclusions: The sensitivity of the QIFN assay is greater than that of the TST in patients with active TB before the initiation of anti-TB chemotherapy, but its specificity is influenced more by bacille Calmette-Gu{\'e}rin vaccination. The QIFN assay may provide an improvement: over the current practice of the use of the TST to support diagnosis of active M tuberculosis infection in the clinic; however, QIFN cannot be considered an adequate replacement for the TST in the screening for latent infection.",
author = "Anna Fietta and Federica Meloni and Alessandro Cascina and Monica Morosini and Carlo Marena and Panaiota Troupioti and Patrizia Mangiarotti and Lucio Casali",
year = "2003",
month = "10",
doi = "10.1016/S0196-6553(02)48240-5",
language = "English",
volume = "31",
pages = "347--353",
journal = "American Journal of Infection Control",
issn = "0196-6553",
publisher = "Mosby Inc.",
number = "6",

}

TY - JOUR

T1 - Comparison of a whole-blood interferon-γ assay and tuberculin skin testing in patients with active tuberculosis and individuals at high or low risk of Mycobacterium tuberculosis infection

AU - Fietta, Anna

AU - Meloni, Federica

AU - Cascina, Alessandro

AU - Morosini, Monica

AU - Marena, Carlo

AU - Troupioti, Panaiota

AU - Mangiarotti, Patrizia

AU - Casali, Lucio

PY - 2003/10

Y1 - 2003/10

N2 - Background: QuantiFeron-TB (QIFN) is a whole-blood interferon-γ assay for the recognition of cell-mediated immune response to Mycobacterium tuberculosis infection. Objectives: To compare the QIFN assay with the tuberculin skin test (TST) in patients with newly diagnosed culture-proven tuberculosis (TB) and healthy volunteers with high or low risk of latent M tuberculosis infection and to identify factors associated with discordance between tests. Method: Two-hundred fifty-eight subjects underwent both assays. All participants completed a detailed questionnaire, and data from TB patients' medical records were collected. Results: In the entire study population, agreement between tests was moderate and the correlation between the magnitude of QIFN response and the TST induration diameter was significant. In volunteers with no known risk of exposure to M tuberculosis, the specificity of the assays was comparable. However, in subjects with active TB or those vaccinated with bacille Calmette-Guérin, the QIFN assay detected more reactors than did the TST. In these individuals, agreement between assays was poor and no correlation or only a weak correlation was found between the diameter of TST induration and the magnitude of the interferon-γ responses. Conclusions: The sensitivity of the QIFN assay is greater than that of the TST in patients with active TB before the initiation of anti-TB chemotherapy, but its specificity is influenced more by bacille Calmette-Guérin vaccination. The QIFN assay may provide an improvement: over the current practice of the use of the TST to support diagnosis of active M tuberculosis infection in the clinic; however, QIFN cannot be considered an adequate replacement for the TST in the screening for latent infection.

AB - Background: QuantiFeron-TB (QIFN) is a whole-blood interferon-γ assay for the recognition of cell-mediated immune response to Mycobacterium tuberculosis infection. Objectives: To compare the QIFN assay with the tuberculin skin test (TST) in patients with newly diagnosed culture-proven tuberculosis (TB) and healthy volunteers with high or low risk of latent M tuberculosis infection and to identify factors associated with discordance between tests. Method: Two-hundred fifty-eight subjects underwent both assays. All participants completed a detailed questionnaire, and data from TB patients' medical records were collected. Results: In the entire study population, agreement between tests was moderate and the correlation between the magnitude of QIFN response and the TST induration diameter was significant. In volunteers with no known risk of exposure to M tuberculosis, the specificity of the assays was comparable. However, in subjects with active TB or those vaccinated with bacille Calmette-Guérin, the QIFN assay detected more reactors than did the TST. In these individuals, agreement between assays was poor and no correlation or only a weak correlation was found between the diameter of TST induration and the magnitude of the interferon-γ responses. Conclusions: The sensitivity of the QIFN assay is greater than that of the TST in patients with active TB before the initiation of anti-TB chemotherapy, but its specificity is influenced more by bacille Calmette-Guérin vaccination. The QIFN assay may provide an improvement: over the current practice of the use of the TST to support diagnosis of active M tuberculosis infection in the clinic; however, QIFN cannot be considered an adequate replacement for the TST in the screening for latent infection.

UR - http://www.scopus.com/inward/record.url?scp=0141483703&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0141483703&partnerID=8YFLogxK

U2 - 10.1016/S0196-6553(02)48240-5

DO - 10.1016/S0196-6553(02)48240-5

M3 - Article

C2 - 14608301

AN - SCOPUS:0141483703

VL - 31

SP - 347

EP - 353

JO - American Journal of Infection Control

JF - American Journal of Infection Control

SN - 0196-6553

IS - 6

ER -