Serial interferon-gamma release assays after rifampicin prophylaxis in a tuberculosis outbreak
Autor: | Sung Weon Ryu, Seung Heon Lee, Woo Jin Lew, Youngmin Lee, Soo Yeon Oh, Chong Hee Cho, Sin Ok Kim, Eun Joo Lee, Hee Jin Kim, Dong Yeol Lee, Hyun Kyung Lee, Tae Sun Shim |
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Rok vydání: | 2010 |
Předmět: |
Adult
Male Pulmonary and Respiratory Medicine medicine.medical_specialty Tuberculosis Adolescent medicine.drug_class Antibiotics Interferon-gamma release assay Interferon gamma release assay Antitubercular Agents Tuberculin Disease Outbreaks Interferon-gamma Young Adult Latent Tuberculosis Internal medicine Republic of Korea Medicine Humans Tuberculosis Pulmonary Antibacterial agent Aged business.industry Tuberculin Test Isoniazid Serial testing Rifampicin prophylaxis Middle Aged bacterial infections and mycoses medicine.disease Immunology Chemoprophylaxis Female Rifampin business Rifampicin medicine.drug |
Zdroj: | Respiratory Medicine. 104(3):448-453 |
ISSN: | 0954-6111 |
DOI: | 10.1016/j.rmed.2009.10.006 |
Popis: | Even though some studies have reported the results of serial interferon-gamma release assays (IGRAs) during isoniazid prophylactic treatment, serial results have not been reported after rifampicin prophylaxis. A contact investigation was conducted after a tuberculosis (TB) outbreak in an accommodation facility. The tuberculin skin test (TST) and the QuantiFERON-TB Gold In-Tube (QFT-GIT) test were performed in 214 contacts with normal chest radiographs. Rifampicin prophylaxis was initiated in TST+/QFT-GIT+ subjects, and the QFT-GIT test was repeated upon completion of 4 months of rifampicin treatment. Among the 214 contacts, the TST and QFT-GIT test results were positive in 67.7% and 56.7%, respectively, and the agreement between the two tests was fair-to-good (78.3%, kappa=0.55, p0.001). The QFT-GIT test was positive in 77% (97/126) of contacts with positive TST results. Rifampicin prophylaxis was completed in 81 subjects with good compliance. Among 74 subjects with valid serial QFT-GIT test results, IFN-gamma levels decreased in 97.3% (72/74) of the subjects and QFT-GIT test reversion (positive to negative) was achieved in 31 subjects (41.9%). Subjects without QFT-GIT test reversion had a significantly higher baseline TST induration sizes (18.3+/-4.8 vs. 14.9+/-3.4mm, p0.01) and IFN-gamma levels (18.6+/-17.9 vs. 3.2+/-7.5IU/mL, p0.01) than the subjects with QFT-GIT test reversion. Thus, IGRAs may be useful in evaluating the therapeutic response to rifampicin prophylaxis in TB contacts. However, considering that this was not a controlled study, a prospective controlled study is needed to determine whether rifampicin prophylaxis truly affects QFT-GIT reversion. |
Databáze: | OpenAIRE |
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