Abstract
Context. A recently developed whole-blood interferon γ (IFN-γ) assay based on stimulation with the Mycobacterium tuberculosis-specific antigens early secreted antigenic target 6 and culture filtrate protein 10 shows promise for the diagnosis of latent tuberculosis (TB) infection. Objective. To compare the tuberculin skin test (TST) and the whole-blood IFN-γ assay in the diagnosis of latent TB infection according to the intensity of exposure. Design and Setting. A prospective comparison between the whole-blood IFN-γ assay and the TST using a 2-TU dose of purified protein derivative RT23 in a population with intermediate TB burden was conducted sequentially between February 1, 2004, and February 28, 2005, in a Korean tertiary referral hospital. Participants. Of 273 participants, 220 (95.7%) had received BCG vaccine. Participants were grouped according to their risk of infection: group 1, no identifiable risk of M tuberculosis infection (n = 99); group 2, recent casual contacts (n = 72); group 3, recent close contacts (n = 48); group 4, bacteriologically or pathologically confirmed TB patients (n = 54). Main Outcome Measures. Levels of agreement between the TST and the IFN-γ assay and the likelihood of infection in the various groups. Results For the TST with a 10-mm induration cutoff, the positive response rate in group 1 was 51%; group 2, 60%; group 3, 71%, and group 4, 78%. For the IFN-γ assay, the positive response rate in group 1 was 4%; group 2, 10%; group 3, 44%; and group 4, 81%. The overall agreement between the TST and the IFN-γ assay in healthy volunteers was κ = 0.16. The odds of a positive test result per unit increase in exposure across the 4 groups increased by a factor of 5.31 (95% confidence interval [CI], 3.62-7.79) for the IFN-γ assay and by a factor of 1.52 (95% CI, 1.20-1.91) for the TST (P<.001). Using a 15-mm induration cutoff for the TST did not make a substantial difference to the test results. Conclusion. The IFN-γ assay is a better indicator of the risk of M tuberculosis infection than TST in a BCG-vaccinated population.
| Original language | English |
|---|---|
| Pages (from-to) | 2756-2761 |
| Number of pages | 6 |
| Journal | Journal of the American Medical Association |
| Volume | 293 |
| Issue number | 22 |
| DOIs | |
| Publication status | Published - 2005 Jun 8 |
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All Science Journal Classification (ASJC) codes
- Medicine(all)
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Discrepancy between the tuberculin skin test and the whole-blood interferon γ assay for the diagnosis of latent tuberculosis infection in an intermediate tuberculosis-burden country. / Young, Ae Kang; Hye, Won Lee; Ho, Il Yoon; Cho, Be Long; Sung, Koo Han; Shim, Young Soo; Yim, Jae Joon.
In: Journal of the American Medical Association, Vol. 293, No. 22, 08.06.2005, p. 2756-2761.Research output: Contribution to journal › Article
TY - JOUR
T1 - Discrepancy between the tuberculin skin test and the whole-blood interferon γ assay for the diagnosis of latent tuberculosis infection in an intermediate tuberculosis-burden country
AU - Young, Ae Kang
AU - Hye, Won Lee
AU - Ho, Il Yoon
AU - Cho, Be Long
AU - Sung, Koo Han
AU - Shim, Young Soo
AU - Yim, Jae Joon
PY - 2005/6/8
Y1 - 2005/6/8
N2 - Context. A recently developed whole-blood interferon γ (IFN-γ) assay based on stimulation with the Mycobacterium tuberculosis-specific antigens early secreted antigenic target 6 and culture filtrate protein 10 shows promise for the diagnosis of latent tuberculosis (TB) infection. Objective. To compare the tuberculin skin test (TST) and the whole-blood IFN-γ assay in the diagnosis of latent TB infection according to the intensity of exposure. Design and Setting. A prospective comparison between the whole-blood IFN-γ assay and the TST using a 2-TU dose of purified protein derivative RT23 in a population with intermediate TB burden was conducted sequentially between February 1, 2004, and February 28, 2005, in a Korean tertiary referral hospital. Participants. Of 273 participants, 220 (95.7%) had received BCG vaccine. Participants were grouped according to their risk of infection: group 1, no identifiable risk of M tuberculosis infection (n = 99); group 2, recent casual contacts (n = 72); group 3, recent close contacts (n = 48); group 4, bacteriologically or pathologically confirmed TB patients (n = 54). Main Outcome Measures. Levels of agreement between the TST and the IFN-γ assay and the likelihood of infection in the various groups. Results For the TST with a 10-mm induration cutoff, the positive response rate in group 1 was 51%; group 2, 60%; group 3, 71%, and group 4, 78%. For the IFN-γ assay, the positive response rate in group 1 was 4%; group 2, 10%; group 3, 44%; and group 4, 81%. The overall agreement between the TST and the IFN-γ assay in healthy volunteers was κ = 0.16. The odds of a positive test result per unit increase in exposure across the 4 groups increased by a factor of 5.31 (95% confidence interval [CI], 3.62-7.79) for the IFN-γ assay and by a factor of 1.52 (95% CI, 1.20-1.91) for the TST (P<.001). Using a 15-mm induration cutoff for the TST did not make a substantial difference to the test results. Conclusion. The IFN-γ assay is a better indicator of the risk of M tuberculosis infection than TST in a BCG-vaccinated population.
AB - Context. A recently developed whole-blood interferon γ (IFN-γ) assay based on stimulation with the Mycobacterium tuberculosis-specific antigens early secreted antigenic target 6 and culture filtrate protein 10 shows promise for the diagnosis of latent tuberculosis (TB) infection. Objective. To compare the tuberculin skin test (TST) and the whole-blood IFN-γ assay in the diagnosis of latent TB infection according to the intensity of exposure. Design and Setting. A prospective comparison between the whole-blood IFN-γ assay and the TST using a 2-TU dose of purified protein derivative RT23 in a population with intermediate TB burden was conducted sequentially between February 1, 2004, and February 28, 2005, in a Korean tertiary referral hospital. Participants. Of 273 participants, 220 (95.7%) had received BCG vaccine. Participants were grouped according to their risk of infection: group 1, no identifiable risk of M tuberculosis infection (n = 99); group 2, recent casual contacts (n = 72); group 3, recent close contacts (n = 48); group 4, bacteriologically or pathologically confirmed TB patients (n = 54). Main Outcome Measures. Levels of agreement between the TST and the IFN-γ assay and the likelihood of infection in the various groups. Results For the TST with a 10-mm induration cutoff, the positive response rate in group 1 was 51%; group 2, 60%; group 3, 71%, and group 4, 78%. For the IFN-γ assay, the positive response rate in group 1 was 4%; group 2, 10%; group 3, 44%; and group 4, 81%. The overall agreement between the TST and the IFN-γ assay in healthy volunteers was κ = 0.16. The odds of a positive test result per unit increase in exposure across the 4 groups increased by a factor of 5.31 (95% confidence interval [CI], 3.62-7.79) for the IFN-γ assay and by a factor of 1.52 (95% CI, 1.20-1.91) for the TST (P<.001). Using a 15-mm induration cutoff for the TST did not make a substantial difference to the test results. Conclusion. The IFN-γ assay is a better indicator of the risk of M tuberculosis infection than TST in a BCG-vaccinated population.
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UR - http://www.scopus.com/inward/citedby.url?scp=20144384031&partnerID=8YFLogxK
U2 - 10.1001/jama.293.22.2756
DO - 10.1001/jama.293.22.2756
M3 - Article
C2 - 15941805
AN - SCOPUS:20144384031
VL - 293
SP - 2756
EP - 2761
JO - JAMA - Journal of the American Medical Association
JF - JAMA - Journal of the American Medical Association
SN - 0002-9955
IS - 22
ER -