Limited usefulness of QuantiFERON-TB GOLD In-Tube® for monitoring anti-tuberculosis therapy

Marialuisa Bocchino, Patrizia Chairadonna, Alessandro Matarese, Dario Bruzzese, Mariella Salvatores, Mirella Tronci, Emilio Moscariello, Domenico Galati, Mario G. Alma, Alessandro Sanduzzi, Alfonso M. Altieri

Research output: Contribution to journalArticle

Abstract

The usefulness of IFN-γ release assays to monitor the efficacy of anti-tuberculosis (TB) treatment is controversial. Sixty patients affected by culture-confirmed pulmonary TB (M = 36; mean age: 39.2 yr; Italians = 28) were serially tested in a low prevalence setting by means of QuantiFERON-TB GOLD In-Tube (QFT-IT) at baseline and after a successful six-month therapy regimen (T6). A sub-group of 40 cases was also tested at 1 and 3 months. Overall, 88.3% of patients scored a QFT-IT positive result at baseline, with the higher proportion of TB-specific IFN-γ responses in foreign-born patients (p = 0.04). TB-specific responses were highly variable over time, the within-person variability being correlated with baseline IFN-γ levels (r = 0.731; p <0.001). Overall, 61.6% of cases still tested QFT-IT positive at the completion of therapy. Average IFN-γ levels increased over time, being persistently significantly higher in Italian patients than in foreign-born cases both at baseline (p = 0.03) and at T6 (p = 0.02). Reversion mainly occurred in patients (26.6%) with baseline IFN-γ levels close to the conventional cut-off value. No indeterminate results were recorded at any study time point. In conclusion, QFT-IT adds no significant information to clinicians for treatment monitoring when applied in routine clinical practice in a low prevalence setting. Kinetics of T cell responses upon TB treatment and reversion (and conversion) thresholds need to be addressed. Diversity of IFN-γ responses among patients of different geographic origin is an issue to be investigated further.

Original languageEnglish
Pages (from-to)1551-1556
Number of pages6
JournalRespiratory Medicine
Volume104
Issue number10
DOIs
Publication statusPublished - Oct 2010

Keywords

  • Interferon-gamma release assays
  • Serial testing
  • Treatment monitoring
  • Tuberculosis

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine

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  • Cite this

    Bocchino, M., Chairadonna, P., Matarese, A., Bruzzese, D., Salvatores, M., Tronci, M., Moscariello, E., Galati, D., Alma, M. G., Sanduzzi, A., & Altieri, A. M. (2010). Limited usefulness of QuantiFERON-TB GOLD In-Tube® for monitoring anti-tuberculosis therapy. Respiratory Medicine, 104(10), 1551-1556. https://doi.org/10.1016/j.rmed.2010.05.011