Use of an interferon-gamma release assay to diagnose latent tuberculosis infection in foreign-born patients

Chest
Daniel BrodieNeil W Schluger

Abstract

The tuberculin skin test (TST) has a low specificity in the setting of bacille Calmette-Guérin (BCG) vaccination. Interferon-gamma release assays (IGRAs) appear to be more specific but have not been validated in this population under routine clinical conditions. We sought to validate the routine clinical use of the T-SPOT.TB test (Oxford Immunotec; Oxford, UK), an IGRA, in a predominantly foreign-born population with a high rate of BCG vaccination. We compared the TST and the T-SPOT.TB test in 96 subjects at a New York City Department of Health tuberculosis clinic. We aimed to determine which test better predicted being a close contact of a case of active tuberculosis, a surrogate for latent tuberculosis infection. A positive T-SPOT.TB test result was strongly associated with being a close contact of a case of active tuberculosis after adjustment for potential confounders (adjusted odds ratio, 2.9; 95% confidence interval, 1.1 to 7.3; p = 0.03). A positive TST result was associated with being a contact only in subjects without BCG vaccination (p = 0.02). The T-SPOT.TB test was more specific for being a close contact than the TST (p < 0.001). Specificity in BCG-vaccinated subjects was 3% for the TST compared with 70% for the T-S...Continue Reading

References

May 10, 2002·The New England Journal of Medicine·Elvin GengNeil W Schluger
Apr 20, 2005·Clinics in Chest Medicine·Daniel Brodie, Neil W Schluger
Aug 6, 2005·American Journal of Respiratory and Critical Care Medicine·Homayoun ShamsPeter F Barnes
Mar 31, 2006·The European Respiratory Journal·R DielT Schaberg
Apr 14, 2006·The European Respiratory Journal·P Wrighton-Smith, J-P Zellweger
Dec 16, 2006·American Journal of Respiratory and Critical Care Medicine·Sandra M ArendAilko W J Bossink

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Citations

Mar 29, 2014·Annals of the American Thoracic Society·Barbara J SeaworthEdward A Nardell
Aug 5, 2010·Chest·Alkesh Kumar Khurana, Ujjawal Khurana
Dec 9, 2010·Chest·Neil W Schluger, Joseph Burzynski
Jun 11, 2010·Transplant Infectious Disease : an Official Journal of the Transplantation Society·M A FitzpatrickM G Ison
Jan 14, 2012·Revue des maladies respiratoires·A FournierS Larnaudie
May 25, 2013·Workplace Health & Safety·Maureen Gonzalez, Helen Acree Conlon
Sep 5, 2015·Revue des maladies respiratoires·A FournierS Quelet
Sep 23, 2014·JBJS Reviews·S RajasekaranAjoy Prasad Shetty
Aug 28, 2009·Clinical and Vaccine Immunology : CVI·Willeke P J FrankenSandra M Arend
Dec 24, 2018·Global Spine Journal·S RajasekaranRishi Mugesh Kanna

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