Reversions of QuantiFERON-TB Gold Plus in tuberculosis contact investigation: A prospective multicentre cohort study.

Autor: Pérez-Recio S; Tuberculosis Unit, Department of Infectious Diseases, Bellvitge University Hospital-Bellvitge Biomedical Research Institute (IDIBELL), L'Hospitalet de Llobregat, Barcelona, Spain., Grijota-Camino MD; Tuberculosis Unit, Department of Infectious Diseases, Bellvitge University Hospital-Bellvitge Biomedical Research Institute (IDIBELL), L'Hospitalet de Llobregat, Barcelona, Spain.; Department of Fundamental and Medical-Surgical Nursing, University of Barcelona, L'Hospitalet de Llobregat, Barcelona, Spain., Anibarro L; Tuberculosis Unit, Department of Internal Medicine, Complexo Hospitalario Universitario de Pontevedra, Pontevedra, Spain., Rabuñal-Rey R; Infectious Diseases Unit, Department of Internal Medicine, University Hospital Lucus Augusti, Lugo, Spain., Sabria J; Tuberculosis Unit, Hospital Moisès Broggi, Sant Joan Despí, Barcelona, Spain., Gijón-Vidaurreta P; Clinical Microbiology and Infectious Diseases, Hospital General Universitario Gregorio Marañon, Madrid, Spain.; Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Madrid, Spain., Pomar V; Infectious Diseases Unit, Department of Internal Medicine, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain., García-Gasalla M; Department of Internal Medicine, Hospital Universitari Son Espases, Palma, Spain.; Balearic Islands Health Research Institute (IdISBa), Palma, Spain., Domínguez-Castellano Á; Clinic Unit of Infectious Diseases and Preventive Medicine, Hospital Virgen Macarena, Sevilla, Spain., Trigo M; Microbiology Department, Complexo Hospitalario Universitario de Pontevedra, Pontevedra, Spain., Santos MJ; Tuberculosis Unit, Hospital Lucus Augusti, Lugo, Spain., Cebollero A; Department of Clinical Analysis, CLILAB Diagnostics Laboratory, Vilafranca del Penedés, Barcelona, Spain., Rodríguez S; Clinical Microbiology and Infectious Diseases, Hospital General Universitario Gregorio Marañon, Madrid, Spain.; Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Madrid, Spain., Moga E; Department of Immunology, Hospital de la Santa Creu i Sant Pau, Biomedical Research Institute Sant Pau (IIB Sant Pau), Barcelona, Spain., Penas-Truque A; Tuberculosis Unit, Hospital Lucus Augusti, Lugo, Spain., Martos C; Tuberculosis Unit, Hospital Moisès Broggi, Sant Joan Despí, Barcelona, Spain., Ruiz-Serrano MJ; Clinical Microbiology and Infectious Diseases, Hospital General Universitario Gregorio Marañon, Madrid, Spain.; Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Madrid, Spain.; Centro de Investigación Biomédica en Red (CIBER) de Enfermedades Respiratorias- CIBERES (CB06/06/0058), Madrid, Spain., Garcia-de-Cara EI; Department of Microbiology, Bellvitge University Hospital-Bellvitge Biomedical Research Institute (IDIBELL), L'Hospitalet de Llobregat, Barcelona, Spain., Alcaide F; Department of Microbiology, Bellvitge University Hospital-Bellvitge Biomedical Research Institute (IDIBELL), L'Hospitalet de Llobregat, Barcelona, Spain.; Department of Pathology and Experimental Therapy, University of Barcelona, L'Hospitalet de Llobregat, Barcelona, Spain., Santin M; Tuberculosis Unit, Department of Infectious Diseases, Bellvitge University Hospital-Bellvitge Biomedical Research Institute (IDIBELL), L'Hospitalet de Llobregat, Barcelona, Spain.; Department of Clinical Sciences, University of Barcelona, L'Hospitalet de Llobregat, Barcelona, Spain.; Centre for Biomedical Research in Infectious Diseases Network (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain.
Jazyk: angličtina
Zdroj: PloS one [PLoS One] 2023 Aug 30; Vol. 18 (8), pp. e0285917. Date of Electronic Publication: 2023 Aug 30 (Print Publication: 2023).
DOI: 10.1371/journal.pone.0285917
Abstrakt: Background: Interferon-y Release Assays (IGRA) reversions have been reported in different clinical scenarios for the diagnosis of tuberculosis (TB) infection. This study aimed to determine the rate of QuantiFERON-TB Gold Plus (QFT-Plus) reversions during contact investigation as a potential strategy to reduce the number of preventive treatments.
Methods: Prospective, multicentre cohort study of immunocompetent adult contacts of patients with pulmonary TB tested with QFT-Plus. Contacts with an initial positive QFT-Plus (QFT-i) underwent a second test within 4 weeks (QFT-1), and if negative, underwent a repeat test 4 weeks later (QFT-2). Based on the QFT-2 result, we classified cases as sustained reversion if they remained negative and as temporary reversion if they turned positive.
Results: We included 415 contacts, of whom 96 (23.1%) had an initial positive test (QFT-i). Following this, 10 had negative QFT-1 results and 4 (4.2%) of these persisted with a negative result in the QFT-2 (sustained reversions). All four sustained reversions occurred in contacts with IFN-γ concentrations between ≥0.35 and ≤0.99 IU•mL-1 in one or both QFT-i tubes.
Conclusion: In this study, TB contact investigations rarely reveal QFT-Plus reversion. These results do not support retesting cases with an initial positive result to reduce the number of preventive treatments.
Competing Interests: The authors have read the journal’s policy and the authors of this manuscript have the following competing interests: M. S. received fees for participating in an advisory board with Pfizer Ltd (2 hours). The remaining authors declare no conflicts of interest. This does not alter our adherence to PLOS ONE policies on sharing data and materials.
(Copyright: © 2023 Pérez-Recio et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)
Databáze: MEDLINE
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