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 |
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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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