Abstract
Objective: The purpose of this study was to examine the usefulness of the TST and the interferon-γ release assays (IGRA) for diagnosing smear-negative pulmonary TB in immunocompromised patients in an intermediate TB burden. Methods: We conducted a prospective study enrolling 119 immunocompromised participants with suspected smear-negative pulmonary TB in Seoul, South Korea. Clinical assessment, TST, QuantiFERON-TB Gold In Tube (QFT-GIT), and T-SPOT.TB were performed in immunosuppressed condition. Results: All participants were categorized according to the type of immunosuppression: 29 patients with diabetes mellitus, 53 with malignancy, 23 with taking immunosuppressive drugs, and 14 with end stage renal disease. IGRA sensitivity and specificity (95% CI) were: QFT-GIT [59.0% (44.9-72.0)] and [61.3% (54.4-67.6)] and T-SPOT.TB [72.0% (54.2-86.2)] and [42.3% (33.8-49.1)], respectively. For TST, sensitivity was 41.2% (28.3-50.8) and specificity was 91.8% (85.8-96.30). The sensitivities of the three diagnostic methods tended to be lower in the immunosuppressive drug group than in other groups (QFT-GIT 11.1%, T-SPOT.TB 40.0% and TST 25.0% in patients with taking immunosuppressive drugs). Among 111 patients who underwent a chest CT examination, there were no significant differences in the CT findings between the immunocompromised TB and non-TB patients. Conclusions: The IGRAs and TST had no value as a single test either to rule-in or rule-out active TB in immunocompromised patients in an intermediate burden.
| Original language | English |
|---|---|
| Pages (from-to) | 188-196 |
| Number of pages | 9 |
| Journal | Journal of Infection |
| Volume | 64 |
| Issue number | 2 |
| DOIs | |
| Publication status | Published - 2012 Feb 1 |
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All Science Journal Classification (ASJC) codes
- Microbiology (medical)
- Infectious Diseases
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Questionable role of interferon-γ assays for smear-negative pulmonary TB in immunocompromised patients. / Jung, Ji Ye; Lim, Ju Eun; Lee, Hye jeong; Kim, Young Mi; Cho, Sang Nae; Kim, Se Kyu; Chang, Joon; Kang, Young Ae.
In: Journal of Infection, Vol. 64, No. 2, 01.02.2012, p. 188-196.Research output: Contribution to journal › Article
TY - JOUR
T1 - Questionable role of interferon-γ assays for smear-negative pulmonary TB in immunocompromised patients
AU - Jung, Ji Ye
AU - Lim, Ju Eun
AU - Lee, Hye jeong
AU - Kim, Young Mi
AU - Cho, Sang Nae
AU - Kim, Se Kyu
AU - Chang, Joon
AU - Kang, Young Ae
PY - 2012/2/1
Y1 - 2012/2/1
N2 - Objective: The purpose of this study was to examine the usefulness of the TST and the interferon-γ release assays (IGRA) for diagnosing smear-negative pulmonary TB in immunocompromised patients in an intermediate TB burden. Methods: We conducted a prospective study enrolling 119 immunocompromised participants with suspected smear-negative pulmonary TB in Seoul, South Korea. Clinical assessment, TST, QuantiFERON-TB Gold In Tube (QFT-GIT), and T-SPOT.TB were performed in immunosuppressed condition. Results: All participants were categorized according to the type of immunosuppression: 29 patients with diabetes mellitus, 53 with malignancy, 23 with taking immunosuppressive drugs, and 14 with end stage renal disease. IGRA sensitivity and specificity (95% CI) were: QFT-GIT [59.0% (44.9-72.0)] and [61.3% (54.4-67.6)] and T-SPOT.TB [72.0% (54.2-86.2)] and [42.3% (33.8-49.1)], respectively. For TST, sensitivity was 41.2% (28.3-50.8) and specificity was 91.8% (85.8-96.30). The sensitivities of the three diagnostic methods tended to be lower in the immunosuppressive drug group than in other groups (QFT-GIT 11.1%, T-SPOT.TB 40.0% and TST 25.0% in patients with taking immunosuppressive drugs). Among 111 patients who underwent a chest CT examination, there were no significant differences in the CT findings between the immunocompromised TB and non-TB patients. Conclusions: The IGRAs and TST had no value as a single test either to rule-in or rule-out active TB in immunocompromised patients in an intermediate burden.
AB - Objective: The purpose of this study was to examine the usefulness of the TST and the interferon-γ release assays (IGRA) for diagnosing smear-negative pulmonary TB in immunocompromised patients in an intermediate TB burden. Methods: We conducted a prospective study enrolling 119 immunocompromised participants with suspected smear-negative pulmonary TB in Seoul, South Korea. Clinical assessment, TST, QuantiFERON-TB Gold In Tube (QFT-GIT), and T-SPOT.TB were performed in immunosuppressed condition. Results: All participants were categorized according to the type of immunosuppression: 29 patients with diabetes mellitus, 53 with malignancy, 23 with taking immunosuppressive drugs, and 14 with end stage renal disease. IGRA sensitivity and specificity (95% CI) were: QFT-GIT [59.0% (44.9-72.0)] and [61.3% (54.4-67.6)] and T-SPOT.TB [72.0% (54.2-86.2)] and [42.3% (33.8-49.1)], respectively. For TST, sensitivity was 41.2% (28.3-50.8) and specificity was 91.8% (85.8-96.30). The sensitivities of the three diagnostic methods tended to be lower in the immunosuppressive drug group than in other groups (QFT-GIT 11.1%, T-SPOT.TB 40.0% and TST 25.0% in patients with taking immunosuppressive drugs). Among 111 patients who underwent a chest CT examination, there were no significant differences in the CT findings between the immunocompromised TB and non-TB patients. Conclusions: The IGRAs and TST had no value as a single test either to rule-in or rule-out active TB in immunocompromised patients in an intermediate burden.
UR - http://www.scopus.com/inward/record.url?scp=84855903953&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84855903953&partnerID=8YFLogxK
U2 - 10.1016/j.jinf.2011.09.008
DO - 10.1016/j.jinf.2011.09.008
M3 - Article
C2 - 22120597
AN - SCOPUS:84855903953
VL - 64
SP - 188
EP - 196
JO - Journal of Infection
JF - Journal of Infection
SN - 0163-4453
IS - 2
ER -