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Comparison of QuantiFERON-TB Gold test and tuberculin skin test for the identification of latent Mycobacterium tuberculosis infection in lupus patients.
Yilmaz, N; Zehra Aydin, S; Inanc, N; Karakurt, S; Direskeneli, H; Yavuz, S.
Afiliación
  • Yilmaz N; Rheumatology, Marmara University Faculty of Medicine, Turkey. dr.yilmazneslihan@gmail.com
Lupus ; 21(5): 491-5, 2012 Apr.
Article en En | MEDLINE | ID: mdl-22140142
ABSTRACT
UNLABELLED The tuberculin skin test (TST) has low sensitivity for the diagnosis of tuberculosis (TB). QuantiFERON-TB Gold (QFT-G) is an IFN-gamma-release assay that measures the release of interferon-gamma after stimulation in vitro by Mycobacterium tuberculosis antigens using ELISA. The main advantage of this assay compared with TST is the lack of cross-reaction with Bacillus Calmette-Guérin (BCG) as well as most of non-tuberculous mycobacteria. The aim of our study is to compare QFT-G with TST for the detection of latent tuberculosis infection (LTBI) among patients with systemic lupus erythematosus (SLE).

METHODS:

Seventy-eight patients with SLE and 49 healthy subjects (HCs) participated in the study. All patients and controls were interviewed for a history of TB then BCG vaccinations were recorded and chest X-rays were examined for a sign of TB infection. QTF-G and TST were performed on both patients and controls. QTF-G results were recorded as positive, negative or indeterminate. A positive TST for SLE was defined as ≥5 mm.

RESULTS:

Seventy-six SLE patients (97.4%) had been BCG vaccinated. Similar to the HC (28.5%), 19 of 78 (24.3%) SLE patients had positive QTF-G. Two patients had an indeterminate result. The agreement between QTF-G and TST was 49/76 (64.4%) (κ = 0.33). There were fewer positive QFT-G test results than positive TST results (24.3% vs. 50%; p < 0.01). Twenty-two (28.9%) patients were TST(+)/QTF-G(-) while only 3(3.9%) patients were TST(-)/QTF-G(+). When the positive TST was defined as ≥10 mm indurations, which is the cut-off in screening for LTBI in Turkey, the agreement between two tests increased up to 58/76 (76.3%) with a κ value of 0.47. The mean TST measurements was higher in QTF-G positive patients (13.4 ± 8.8 mm) than the QTF-G negative patients (4 ± 5.3 mm) (p < 0.001).

DISCUSSION:

In a TB-endemic and BCG vaccinated population, the QuantiFERON-TB Gold assay seemed to be a more accurate test for the detection of LTBI in SLE patients. Although 5 mm is usually accepted to be the standard cut-off for TST in immunocompromised patients such as SLE, the level of agreement between QTF-G and TST was better with a 10 mm cut-off in our population.
Asunto(s)

Texto completo: 1 Base de datos: MEDLINE Asunto principal: Prueba de Tuberculina / Tuberculosis Latente / Ensayos de Liberación de Interferón gamma / Lupus Eritematoso Sistémico Tipo de estudio: Diagnostic_studies / Observational_studies / Risk_factors_studies Idioma: En Revista: Lupus Asunto de la revista: REUMATOLOGIA Año: 2012 Tipo del documento: Article

Texto completo: 1 Base de datos: MEDLINE Asunto principal: Prueba de Tuberculina / Tuberculosis Latente / Ensayos de Liberación de Interferón gamma / Lupus Eritematoso Sistémico Tipo de estudio: Diagnostic_studies / Observational_studies / Risk_factors_studies Idioma: En Revista: Lupus Asunto de la revista: REUMATOLOGIA Año: 2012 Tipo del documento: Article