SETTING: Persons in whom targeted testing for latent tuberculosis infection (LTBI) is recommended in Seattle, Washington; Atlanta, Georgia; and central North Carolina, United States. OBJECTIVE: To compare the performance of an interferon-gamma release assay (QuantiFERON®-TB Gold In-Tube [QFT-GIT]) with the tuberculin skin test (TST) among foreign-born, homeless, human immunodeficiency virus (HIV) infected and substance abuse persons tested for LTBI. DESIGN: A cross-sectional study requiring participants to have a blood test, a TST and data collected. RESULTS: Of 1653 persons, 19.5% were TST-positive and 14.0% were QFT-GIT-positive. Overall concordance was moderate (kappa 0.53; 95%CI 0.47-0.58). Compared to concordant positive results, TST+/QFT-GIT- discordance was associated with HIV infection and sex, while TST-/QFT-GIT+ discordance was associated with HIV and inversely associated with foreign birth. Compared to concordant negative results, TST-/QFT-GIT+ discordance was associated with foreign birth and age ≥50 years, while TST+/QFT-GIT-discordance was associated with foreign birth, age 30-49 years, being Black and inversely associated with HIV. HIV infection was significantly associated with indeterminate QFT-GIT results. CONCLUSION: QFT-GIT may be an improvement over the TST for diagnosing LTBI in foreign-born and older persons, and may be as useful as the TST in HIV-infected persons. The sensitivity of both tests may be low in HIV-infected persons.
SETTING:Persons in whom targeted testing for latent tuberculosis infection (LTBI) is recommended in Seattle, Washington; Atlanta, Georgia; and central North Carolina, United States. OBJECTIVE: To compare the performance of an interferon-gamma release assay (QuantiFERON®-TB Gold In-Tube [QFT-GIT]) with the tuberculin skin test (TST) among foreign-born, homeless, human immunodeficiency virus (HIV) infected and substance abuse persons tested for LTBI. DESIGN: A cross-sectional study requiring participants to have a blood test, a TST and data collected. RESULTS: Of 1653 persons, 19.5% were TST-positive and 14.0% were QFT-GIT-positive. Overall concordance was moderate (kappa 0.53; 95%CI 0.47-0.58). Compared to concordant positive results, TST+/QFT-GIT- discordance was associated with HIV infection and sex, while TST-/QFT-GIT+ discordance was associated with HIV and inversely associated with foreign birth. Compared to concordant negative results, TST-/QFT-GIT+ discordance was associated with foreign birth and age ≥50 years, while TST+/QFT-GIT-discordance was associated with foreign birth, age 30-49 years, being Black and inversely associated with HIV. HIV infection was significantly associated with indeterminate QFT-GIT results. CONCLUSION: QFT-GIT may be an improvement over the TST for diagnosing LTBI in foreign-born and older persons, and may be as useful as the TST in HIV-infectedpersons. The sensitivity of both tests may be low in HIV-infectedpersons.
Authors: M E Castellanos; S Kirimunda; L Martinez; T Quach; H Woldu; R Kakaire; A Handel; S Zalwango; N Kiwanuka; C C Whalen Journal: Int J Tuberc Lung Dis Date: 2018-09-01 Impact factor: 2.373
Authors: Jonathon R Campbell; Wenjia Chen; James Johnston; Victoria Cook; Kevin Elwood; Jane Krot; Fawziah Marra Journal: Mol Diagn Ther Date: 2015-04 Impact factor: 4.074
Authors: Jason E Stout; Yanjue Wu; Christine S Ho; April C Pettit; Pei-Jean Feng; Dolly J Katz; Smita Ghosh; Thara Venkatappa; Ruiyan Luo Journal: Thorax Date: 2018-07-07 Impact factor: 9.139
Authors: Bijan J Ghassemieh; Engi F Attia; David M Koelle; James D Mancuso; Masahiro Narita; David J Horne Journal: Am J Respir Crit Care Med Date: 2016-08-15 Impact factor: 21.405