Analysis of factors lowering sensitivity of interferon-γ release assay for tuberculosis.
| Autor: | Hang NT; NCGM-BMH Medical Collaboration Center, Hanoi, Viet Nam., Lien LT, Kobayashi N, Shimbo T, Sakurada S, Thuong PH, Hong LT, Tam DB, Hijikata M, Matsushita I, Hung NV, Higuchi K, Harada N, Keicho N |
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| Jazyk: | angličtina |
| Zdroj: | PloS one [PLoS One] 2011; Vol. 6 (8), pp. e23806. Date of Electronic Publication: 2011 Aug 19. |
| DOI: | 10.1371/journal.pone.0023806 |
| Abstrakt: | Background: Imperfect sensitivity of interferon-γ release assay (IGRA) is a potential problem to detect tuberculosis. We made a thorough investigation of the factors that can lead to false negativity of IGRA. Methods: We recruited 543 patients with new smear-positive pulmonary tuberculosis in Hanoi, Viet Nam. At diagnosis, peripheral blood was collected and IGRA (QuantiFERON-TB Gold In-Tube) was performed. Clinical and epidemiological information of the host and pathogen was collected. The test sensitivity was calculated and factors negatively influencing IGRA results were evaluated using a logistic regression model in 504 patients with culture-confirmed pulmonary tuberculosis. Results: The overall sensitivity of IGRA was 92.3% (95% CI, 89.6%-94.4%). The proportions of IGRA-negative and -indeterminate results were 4.8% (95% CI, 3.1%-7.0%) and 3.0% (95% CI, 1.7%-4.9%). Age increased by year, body mass index <16.0, HIV co-infection and the increased number of HLA-DRB1*0701 allele that patients bear showed significant associations with IGRA negativity (OR = 1.04 [95% CI, 1.01-1.07], 5.42 [1.48-19.79], 6.38 [1.78-22.92] and 5.09 [2.31-11.22], respectively). HIV co-infection and the same HLA allele were also associated with indeterminate results (OR = 99.59 [95% CI, 15.58-625.61] and 4.25 [1.27-14.16]). Conclusions: Aging, emaciation, HIV co-infection and HLA genotype affected IGRA results. Assessment of these factors might contribute to a better understanding of the assay. |
| Databáze: | MEDLINE |
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