Does an interferon-gamma release assay change practice in possible latent tuberculosis?
QJM
; 106(2): 139-46, 2013 Feb.
Article
in En
| MEDLINE
| ID: mdl-23159840
ABSTRACT
BACKGROUND AND AIMS:
Suspected latent tuberculosis infection (LTBI) is a common reason for referral to TB clinics. Interferon-gamma release assays (IGRAs) are more specific than tuberculin skin tests (TSTs) for diagnosing LTBI. The aim of this study is to determine if IGRA changes practice in the management of cases referred to a TB clinic for possible LTBI. DESIGN ANDMETHODS:
A prospective study was performed over 29 months. All adult patients who had TST, CXR & IGRA were included. The original decision regarding TB chemoprophylaxis was made by TB team consensus, based on clinical history and TST. Cases were then analysed with the addition of IGRA to determine if this had altered management. An independent physician subsequently reviewed the cases.RESULTS:
Of 204 patients studied, 68 were immunocompromised. 120 patients had positive TSTs. Of these, 36 (30%) had a positive QFT and 84 (70%) had a negative QFT. Practice changed in 78 (65%) cases with positive TST, all avoiding TB chemoprophylaxis due to QFT. Of the immunocompromised patients, 17 (25%) underwent change of practice. No cases of active TB have developed.CONCLUSION:
This study demonstrates a significant change of clinical practice due to IGRA use. Our findings support the NICE 2011 recommendations.
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Referral and Consultation
/
Tuberculin Test
/
Latent Tuberculosis
/
Interferon-gamma Release Tests
/
Mycobacterium tuberculosis
Type of study:
Diagnostic_studies
/
Etiology_studies
/
Guideline
/
Observational_studies
/
Prognostic_studies
Limits:
Adult
/
Female
/
Humans
/
Male
Country/Region as subject:
Europa
Language:
En
Journal:
QJM
Journal subject:
MEDICINA
Year:
2013
Document type:
Article
Affiliation country:
Reino Unido