Comparison of interferon-γ release assay to two cut-off points of tuberculin skin test to detect latent Mycobacterium tuberculosis infection in primary health care workers.
<h4>Background</h4>An interferon-γ release assay, QuantiFERON-TB (QFT) test, has been introduced an alternative test for the diagnosis of latent Mycobacterium tuberculosis infection (LTBI). Here, we compared the performance of QFT with tuberculin skin test (TST) measured at two different...
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2014
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oai:doaj.org-article:6fdcfb3f12da47a99678cbfef27e00d32021-11-25T06:04:09ZComparison of interferon-γ release assay to two cut-off points of tuberculin skin test to detect latent Mycobacterium tuberculosis infection in primary health care workers.1932-620310.1371/journal.pone.0102773https://doaj.org/article/6fdcfb3f12da47a99678cbfef27e00d32014-01-01T00:00:00Zhttps://www.ncbi.nlm.nih.gov/pmc/articles/pmid/25137040/pdf/?tool=EBIhttps://doaj.org/toc/1932-6203<h4>Background</h4>An interferon-γ release assay, QuantiFERON-TB (QFT) test, has been introduced an alternative test for the diagnosis of latent Mycobacterium tuberculosis infection (LTBI). Here, we compared the performance of QFT with tuberculin skin test (TST) measured at two different cut-off points among primary health care work (HCW) in Brazil.<h4>Methods</h4>A cross-sectional study was carried out among HCWs in four Brazilian cities with a known history of high incidence of TB. Results of the QFT were compared to TST results based on both ≥5 mm and ≥10 mm as cut-off points.<h4>Results</h4>We enrolled 632 HCWs. When the cut-off value of ≥10 mm was used, agreement between QFT and TST was 69% (k = 0.31), and when the cut-off of ≥5 mm was chosen, the agreement was 57% (k = 0.22). We investigated possible factors of discordance of TST vs QFT. Compared to the TST-/QFT- group, risk factors for discordance in the TST+/QFT- group with TST cut-off of ≥5 mm included age between 41-45 years [OR = 2.70; CI 95%: 1.32-5.51] and 46-64 years [OR = 2.04; CI 95%: 1.05-3.93], BCG scar [OR = 2.72; CI 95%: 1.40-5.25], and having worked only in primary health care [OR = 2.30; CI 95%: 1.09-4.86]. On the other hand, for the cut-off of ≥10 mm, BCG scar [OR = 2.26; CI 95%: 1.03-4.91], being a household contact of a TB patient [OR = 1.72; CI 95%: 1.01-2.92] and having had a previous TST [OR = 1.66; CI 95%: 1.05-2.62], were significantly associated with the TST+/QFT- group. No statistically significant associations were found among the TST-/QFT+ discordant group with either TST cut-off value.<h4>Conclusions</h4>Although we identified BCG vaccination to contribute to the discordance at both TST cut-off measures, the current Brazilian recommendation for the initiation of LTBI treatment, based on information gathered from medical history, TST, chest radiograph and physical examination, should not be changed.Fernanda Mattos de SouzaThiago Nascimento do PradoJair dos Santos PinheiroRenata Lyrio PeresThamy Carvalho LacerdaRafaela Borge LoureiroJose Américo CarvalhoGeisa FregonaElias Santos DiasLorrayne Beliqui CosmeRodrigo Ribeiro RodriguesLee Wood RileyEthel Leonor Noia MacielPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 9, Iss 8, p e102773 (2014) |
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Medicine R Science Q Fernanda Mattos de Souza Thiago Nascimento do Prado Jair dos Santos Pinheiro Renata Lyrio Peres Thamy Carvalho Lacerda Rafaela Borge Loureiro Jose Américo Carvalho Geisa Fregona Elias Santos Dias Lorrayne Beliqui Cosme Rodrigo Ribeiro Rodrigues Lee Wood Riley Ethel Leonor Noia Maciel Comparison of interferon-γ release assay to two cut-off points of tuberculin skin test to detect latent Mycobacterium tuberculosis infection in primary health care workers. |
| description |
<h4>Background</h4>An interferon-γ release assay, QuantiFERON-TB (QFT) test, has been introduced an alternative test for the diagnosis of latent Mycobacterium tuberculosis infection (LTBI). Here, we compared the performance of QFT with tuberculin skin test (TST) measured at two different cut-off points among primary health care work (HCW) in Brazil.<h4>Methods</h4>A cross-sectional study was carried out among HCWs in four Brazilian cities with a known history of high incidence of TB. Results of the QFT were compared to TST results based on both ≥5 mm and ≥10 mm as cut-off points.<h4>Results</h4>We enrolled 632 HCWs. When the cut-off value of ≥10 mm was used, agreement between QFT and TST was 69% (k = 0.31), and when the cut-off of ≥5 mm was chosen, the agreement was 57% (k = 0.22). We investigated possible factors of discordance of TST vs QFT. Compared to the TST-/QFT- group, risk factors for discordance in the TST+/QFT- group with TST cut-off of ≥5 mm included age between 41-45 years [OR = 2.70; CI 95%: 1.32-5.51] and 46-64 years [OR = 2.04; CI 95%: 1.05-3.93], BCG scar [OR = 2.72; CI 95%: 1.40-5.25], and having worked only in primary health care [OR = 2.30; CI 95%: 1.09-4.86]. On the other hand, for the cut-off of ≥10 mm, BCG scar [OR = 2.26; CI 95%: 1.03-4.91], being a household contact of a TB patient [OR = 1.72; CI 95%: 1.01-2.92] and having had a previous TST [OR = 1.66; CI 95%: 1.05-2.62], were significantly associated with the TST+/QFT- group. No statistically significant associations were found among the TST-/QFT+ discordant group with either TST cut-off value.<h4>Conclusions</h4>Although we identified BCG vaccination to contribute to the discordance at both TST cut-off measures, the current Brazilian recommendation for the initiation of LTBI treatment, based on information gathered from medical history, TST, chest radiograph and physical examination, should not be changed. |
| format |
article |
| author |
Fernanda Mattos de Souza Thiago Nascimento do Prado Jair dos Santos Pinheiro Renata Lyrio Peres Thamy Carvalho Lacerda Rafaela Borge Loureiro Jose Américo Carvalho Geisa Fregona Elias Santos Dias Lorrayne Beliqui Cosme Rodrigo Ribeiro Rodrigues Lee Wood Riley Ethel Leonor Noia Maciel |
| author_facet |
Fernanda Mattos de Souza Thiago Nascimento do Prado Jair dos Santos Pinheiro Renata Lyrio Peres Thamy Carvalho Lacerda Rafaela Borge Loureiro Jose Américo Carvalho Geisa Fregona Elias Santos Dias Lorrayne Beliqui Cosme Rodrigo Ribeiro Rodrigues Lee Wood Riley Ethel Leonor Noia Maciel |
| author_sort |
Fernanda Mattos de Souza |
| title |
Comparison of interferon-γ release assay to two cut-off points of tuberculin skin test to detect latent Mycobacterium tuberculosis infection in primary health care workers. |
| title_short |
Comparison of interferon-γ release assay to two cut-off points of tuberculin skin test to detect latent Mycobacterium tuberculosis infection in primary health care workers. |
| title_full |
Comparison of interferon-γ release assay to two cut-off points of tuberculin skin test to detect latent Mycobacterium tuberculosis infection in primary health care workers. |
| title_fullStr |
Comparison of interferon-γ release assay to two cut-off points of tuberculin skin test to detect latent Mycobacterium tuberculosis infection in primary health care workers. |
| title_full_unstemmed |
Comparison of interferon-γ release assay to two cut-off points of tuberculin skin test to detect latent Mycobacterium tuberculosis infection in primary health care workers. |
| title_sort |
comparison of interferon-γ release assay to two cut-off points of tuberculin skin test to detect latent mycobacterium tuberculosis infection in primary health care workers. |
| publisher |
Public Library of Science (PLoS) |
| publishDate |
2014 |
| url |
https://doaj.org/article/6fdcfb3f12da47a99678cbfef27e00d3 |
| work_keys_str_mv |
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1718414228504707072 |