The use of IGRAs and tuberculin skin test in the diagnosis of latent tuberculosis infection
Journal Title: Postępy Nauk Medycznych - Year 2011, Vol 24, Issue 10
Abstract
Introduction. One-third of the world’s population is infected with M. tuberculosis. This large pool of infected individuals poses a major hurdle of tuberculosis control. Due to the risk of progression from latent infection to active disease, identifying persons with latent TB infection is key component of disease elimination.In Poland, where the entire population is BCG vaccinated, it is important to determine whether a positive tuberculin skin test result is associated with a prior BCG vaccination, or with an existing MTB infection. Therefore looking for new methods of diagnosing MTB infection in a stage of latency before the development of the disease. Currently, there are two interferon- gamma release assays for the rapid diagnosis of latent tuberculosis infection: QuantiFERON-TB Gold and T-SPOT.TB.Material and methods. The study included 78 subjects, 25 health care workers (high risk of tuberculosis infection) and 53 patients from the Institute of Tuberculosis and Lung Disease. Of the participants studied performed both interferon-γ release assays: T-SPOT.TB, QuantiFERON-TbGold and a tuberculin skin test TST.Results. Among 78 subjects, 6 (7.7%) were T-SPOT.TB+/QFT-G+/TST+, suggesting that they might in fact be infected with MTB. In the two analyzed groups showed 11 (14.1%) positive T-SPOT.TB results, 12 (15.4%) QuantiFERON-TB Gold and 22 (28.2%) positive TST results. Using 10 mm or more as a cut-off for TST, concordance between T-SPOT.TB and TST was higher in both study groups than that seen for QFT-G and TST. Concordance between interferon-γ release assays was similar in HCWs (92%) and in patients from the Institute of Tuberculosis and Lung Disease (88.5%).Conclusions. The results of IGRAs and TST are discordant. Not all causes of discordances are explicable. The diagnosis of tuberculosis infection cannot be based on a single T-SPOT.TB, QFT-G or TST result.
Authors and Affiliations
Dagmara Borkowska, Zofia Zwolska, Beata Broniarek-Samson, Dorota Michałowska-Mitczuk, Ewa Augustynowicz-Kopeć, Anna Kempisty, Piotr Radwan-Röhrenschef
Keywords
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