Effect of adjusted cut-offs of interferon-γ release assays on diagnosis of tuberculosis in patients with fever of unknown origin
| Autor: | Shen, Yaojie, Qi, Xiao, Wu, Jing, Gao, Yan, Shao, Lingyun, Zhang, Wenhong, Wang, Sen |
|---|---|
| Rok vydání: | 2022 |
| Předmět: |
Microbiology (medical)
Pulmonary and Respiratory Medicine TB tuberculosis Mtb Mycobacterium tuberculosis TST Tuberculin skin test Infectious and parasitic diseases RC109-216 CNS central nervous system ATB active tuberculosis Article Diseases of the respiratory system CFP-10 culture filtrate protein Interferon-γ release assay T-SPOT T-SPOT®.TB ESAT-6 early secreted antigenic target 6 PTB pulmonary tuberculosis Tuberculosis IFN-γ interferon-γ LTBI latent tuberculosis infection T-SPOT.TB PBMCs peripheral blood mononuclear cells SFC spot-forming cells RC705-779 QuantiFERON-TB Gold ROC receiver operating characteristic Infectious Diseases IGRAs interferon-γ release assays BCG Bacillus Calmette–Guérin EPTB extrapulmonary tuberculosis QFT QuantiFERON-TB Gold FUO fever of unknown origin |
| Zdroj: | Journal of Clinical Tuberculosis and Other Mycobacterial Diseases, Vol 26, Iss, Pp 100290-(2022) Journal of Clinical Tuberculosis and Other Mycobacterial Diseases |
| ISSN: | 2405-5794 |
| DOI: | 10.1016/j.jctube.2021.100290 |
| Popis: | Background: Tuberculosis (TB) is a leading cause of fever of unknown origin (FUO). In recent years, interferon-γ release assays (IGRAs) have been widely utilized and the cut-off values given by the manufacturers are set in countries where rates of TB are not as high. Methods: A prospective cohort study was conducted in a Chinese general hospital to evaluate the diagnostic performance of T-SPOT.TB (T-SPOT) and QuantiFERON-TB Gold (QFT) in detecting active TB (ATB) in a high TB endemic area. Test results were compared with the culture and clinically confirmed diagnosis. Further, we explored an alternative method of interpreting IGRAs by increasing the cut-off values. Results: The sensitivity and specificity of T-SPOT in detecting ATB were 85.3% (95% CI 81.6–94.0%) and 71.8% (95% CI 67.3–76.0%), respectively. The sensitivity and specificity of QFT were 72.3% (95% CI 62.8–80.1%) and 77.0% (95% CI 72.7–80.8%), respectively. Receiver operating characteristic analysis was used for evaluation of different cut-off values. When the cut-off values were adjusted as 125 spot-forming cells (SFCs)/ 2.5*105 cells for T-SPOT and 4.0 IU/ml for QFT, the specificity could be improved to > 90.0% (90.3% and 94.1%, respectively), and the sensitivity were 43.1% and 41.6%, respectively. The new adjusted cut-off values were validated in another independent validation cohort. Conclusion: The adjusted cut-off values of the two assays considerably improved the diagnostic value when applied to FUO patients in clinical settings. |
| Databáze: | OpenAIRE |
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