Document Detail


Questionable role of interferon-γ assays for smear-negative pulmonary TB in immunocompromised patients.
MedLine Citation:
PMID:  22120597     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
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), 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.
Authors:
Ji Ye Jung; Ju Eun Lim; Hye-Jeong Lee; Young Mi Kim; Sang-Nae Cho; Se Kyu Kim; Joon Chang; Young Ae Kang
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-11-18
Journal Detail:
Title:  The Journal of infection     Volume:  -     ISSN:  1532-2742     ISO Abbreviation:  -     Publication Date:  2011 Nov 
Date Detail:
Created Date:  2011-11-28     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7908424     Medline TA:  J Infect     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2011. Published by Elsevier Ltd.
Affiliation:
Department of Internal Medicine, Yonsei University College of Medicine, Seoul, South Korea.
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