Borderline QuantiFERON results and the distinction between specific responses and test variability

Autor: Jonathan W. Uzorka, Sandra M. Arend, Willeke P. J. Franken, Ailko W. J. Bossink, Alida C. van Haeften, Eliane M. S. Leyten, Peter Boonstra, Tom H. M. Ottenhoff, Gert Doornenbal, Steven Thijsen
Jazyk: angličtina
Rok vydání: 2018
Předmět:
Microbiology (medical)
Male
medicine.medical_specialty
Enzyme-Linked Immunospot Assay
Tuberculosis
Time Factors
Adolescent
Immunology
Tuberculin
Microbiology
QuantiFERON
Mycobacterium tuberculosis
03 medical and health sciences
Interferon-gamma
Young Adult
0302 clinical medicine
Latent Tuberculosis
Predictive Value of Tests
Internal medicine
Medicine
Humans
Clinical significance
In patient
030212 general & internal medicine
Retrospective Studies
Interferon-gamma release tests
biology
business.industry
Tuberculin Test
Reproducibility of Results
Cut-off
Middle Aged
bacterial infections and mycoses
medicine.disease
biology.organism_classification
Prognosis
Test (assessment)
Infectious Diseases
Elispot
030228 respiratory system
Biological significance
Host-Pathogen Interactions
Female
business
Biomarkers
Zdroj: Tuberculosis, 111, 102-108
Popis: QuantiFERON (QFT) results near the cut-off are subject to debate. We aimed to investigate which borderline QFT results were due to Mycobacterium tuberculosis (Mtb)-specific responses or to test variability.In a contact investigation, tuberculin skin test (TST), QFT and T-SPOT.TB (T-SPOT) were performed in 785 BCG-unvaccinated contacts. Contacts with a low-negative (0.15), borderline (0.15-0.35), low-positive (0.35-0.70) or high-positive QFT (≥0.70 IU/mL) were compared with respect to exposure, TST and T-SPOT results. Development of active tuberculosis was assessed.Borderline QFT results occurred in threefold excess over test variability (p = 0.0027). In contacts with low-negative, borderline or positive QFT results, a positive TST occurred in 24.9%, 62.1% and 91.4% (p 0.0001) and a positive T-SPOT result in 6.3%, 41.3% and 86.4%, respectively (p 0.0001). Two-third (20/29) of contacts with a borderline and 14/16 (88%) with a low-positive QFT had a positive TST and/or T-SPOT, indicating probable Mtb-infection. During 12 years of follow-up, seven patients were diagnosed with active tuberculosis, two of whom after a low-positive QFT.In this study, most borderline and low-positive QFT results were Mtb-specific, showing the biological significance of a borderline QFT. The clinical relevance, however, will be most distinct in patients who are or will be immunocompromised.
Databáze: OpenAIRE
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