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:: Volume 11, Number 2 (May - June 2017) ::
Iran J Med Microbiol 2017, 11(2): 17-25 Back to browse issues page
Comparison of Interferon-Gamma Release and Tuberculin Skin Test for Detection of Latent Tuberculosis Infections in Iranian Elderly Patients
Azadeh Mansourzadeh1, Sahar Honarmand Jahromi1, Majid Khoshmirsafa2, Reza Falak *3
1- Department of Microbiology, Islamic Azad University, Varamin Branch, Tehran, Iran
2- Immunology Research Center, Iran University of Medical Sciences, Tehran, Iran
3- Immunology Research Center, Iran University of Medical Sciences, Tehran, Iran , Rezafalak@yahoo.com
Abstract:   (318 Views)

Background and Aims: Tuberculin skin test is a common method for diagnosis of latent tuberculosis but it has a high rate of false positivity and false negativity. In Quantiferon test, the interferon gamma secreted by lymphocytes in response to Mycobacterium tuberculosis antigens is measured. This study aimed to determine the rate of agreement between quantiferon with skin tuberculin induration in the diagnosis of latent tuberculosis in elderly.

Materials and Methods: This study was carried out in 2015 on 10 elderly patients with confirmed active tuberculosis, 30 elderly patients with latent tuberculosis and 50 elderly individuals without any respiratory symptoms at Iran University of Medical Sciences, Tehran, Iran. The secretion of gamma interferon of specific T cells in peripheral blood was measured using Quantiferon test. In addition the tuberculin skin test was performed using standard methods and the skin induration was measured. By drawing the ROC curve, sensitivity, specificity, and under the curve area (AUC) was calculated interferon gamma release and tuberculin test. Results of patients and healthy people were compared with the Kruskal-Wallis test.

Results: The sensitivity and specificity of gamma interferon release test for active tuberculosis in elderly patients was, 100% and 98% respectively (area under the curve 0.99) while the sensitivity and specificity of the tuberculin test was respectively 80% and 94% (area under the curve 0.89). Regarding to elderly patients with latent tuberculosis the sensitivity and specificity of interferon-gamma release test was 73% and 98%, respectively; and the sensitivity and specificity of tuberculin test in these patients was 36% and 94%, respectively.

Conclusions: Quantiferon is more sensitive and specific test for diagnosis of latent tuberculosis and application of this method is more reliable for diagnosis of latent tuberculosis infection in the elderly.

Keywords: Latent tuberculosis, Quantiferon, Tuberculin skin test
Full-Text [PDF 707 kb]   (47 Downloads)    
Type of Study: Original | Subject: Medical Bacteriology
References
1. Sulis G, Roggi A, Matteelli A, Raviglione MC. Tuberculosis: epidemiology and control. Mediterr J Hematol Infect Dis 2014;6(1):e2014070. [PubMed]
2. Dye C, Williams BG. Eliminating human tuberculosis in the twenty-first century. J R Soc Interface 2008;5(23):653-62. [PubMed]
3. Comstock GW, Livesay VT, Woolpert SF. The prognosis of a positive tuberculin reaction in childhood and adolescence. Am J Epidemiol 1974;99(2):131-8. [PubMed]
4. Wang L, Turner MO, Elwood RK, Schulzer M, FitzGerald JM. A meta-analysis of the effect of Bacille Calmette Guerin vaccination on tuberculin skin test measurements. Thorax 2002;57(9):804-9. [PubMed]
5. Cobelens FG, Egwaga SM, van Ginkel T, Muwinge H, Matee MI, Borgdorff MW. Tuberculin skin testing in patients with HIV infection: limited benefit of reduced cutoff values. Clin Infect Dis 2006;43(5):634-9. [PubMed]
6. Mazurek GH, Villarino ME. Guidelines for Using the QuantiFERON®-TB Test for Diagnosing Latent Mycobacterium tuberculosis Infection. 2003, CDC Recommendations and Reports 52:15-18. [Article]
7. Rothel JS and Radford AJ. Comparison of Tuberculosis Tests: Finding Truth or Confirming Prejudice? Clin Infect Dis 2003;36(9):1206-1207 [PubMed]
8. Lalvani A, Pareek M. Interferon gamma release assays: principles and practice. Enfermedades infecciosas y microbiologia clinica 2010; 28(4):245-52. [PubMed]
9. Mazurek GH, Weis SE, Moonan PK, Daley CL, et al. Prospective Comparison of the Tuberculin Skin Test and 2 Whole-Blood Interferon-γ Release Assays in Persons with Suspected Tuberculosis. Clin Infect Dis 2007;45(7):837-845. [PubMed]
10. Gledovic Z, Vlajinac H, Pekmezovic T, Grujicic-Sipetic S, Grgurevic A, Pesut D. Burden of tuberculosis in Serbia. Am J Infect Control 2006;34(10):676-9. [PubMed]
11. Pawlowski A, Jansson M, Skold M, Rottenberg ME, Kallenius G. Tuberculosis and HIV co-infection. PLoS pathogens 2012;8(2):e1002464. [Article]
12. Chapman AL. New tests will improve detection of latent TB. The Practitioner 2011; 255(1745):23-6, 2-3. [PubMed]
13. Norton BL, Holland DP. Current management options for latent tuberculosis: a review. Infect Drug Resist 2012;5:163-73. [PubMed]
14. Eum SY, Lee YJ, Kwak HK, Min JH, Hwang SH, Via LE, et al. Evaluation of the diagnostic utility of a whole-blood interferon-gamma assay for determining the risk of exposure to Mycobacterium tuberculosis in Bacille Calmette-Guerin (BCG)-vaccinated individuals. Diagn Microbiol Dis 2008;61(2):181-6. [PubMed]
15. Connell TG, Ritz N, Paxton GA, Buttery JP, Curtis N, Ranganathan SC. A three-way comparison of tuberculin skin testing, QuantiFERON-TB gold and T-SPOT.TB in children. PloS one 2008;3(7):e2624. [PubMed]
16. Vaziri S, Khazaei S, Neshaboori SM, Molaei Tavana P, Kanani M, Madani SH. The degree of agreement of quantiferon TB gold test and tuberculin skin test in Nurses. J Gorgan Univ Med Sci 2010: 13(1):37-43. [Article]
17. Hermansen TS, Thomsen VO, Lillebaek T, Ravn P. Non-tuberculous mycobacteria and the performance of interferon gamma release assays in Denmark. PloS one 2014;9(4):e93986. [Article]
18. Detjen AK, Keil T, Roll S, Hauer B, Mauch H, Wahn U, et al. Interferon-gamma release assays improve the diagnosis of tuberculosis and nontuberculous mycobacterial disease in children in a country with a low incidence of tuberculosis. Clin Infect Dis. 2007;45(3):322-8. [PubMed]
19. Harada N, Higuchi K, Yoshiyama T, Kawabe Y, FujitaA, Sasaki Y, et al. Comparison of the sensitivity and specificity of two whole blood interferon-gamma assays for M. tuberculosis infection. The Journal of infection 2008;56(5):348-53. [PubMed]
20. Pai M, Zwerling A, Menzies D. Systematic review: T-cell-based assays for the diagnosis of latent tuberculosis infection: an update. Ann Intern Med 2008;149(3):177-84. [PubMed]
21. Lashkardoost H ZB, Mahmoudi M, Hassanzadeh J, Hamedi A, H T. ssessment of Quanti FERON-TB Gold (In-Tube) Test in Tuberculosis Diagnosis. IJE 2010; 6 (1):26-32.
22. Dewan PK, Grinsdale J, Kawamura LM. Low sensitivity of a whole-blood interferon-gamma release assay for detection of active tuberculosis. Clin Infect Dis 2007;44(1):69-73. [PubMed]
23. Hang NT, Lien LT, Kobayashi N, Shimbo T, Sakurada S, Thuong PH, et al. Analysis of factors lowering sensitivity of interferon-gamma release assay for tuberculosis. PloS one 2011;6(8):e23806. [Article]
24. Kim EY, Park MS, Kim YS, Kim SK, Chang J, Kang YA. Risk factors for false-negative results of QuantiFERON-TB Gold In-Tube assay in non-HIV-infected patients with culture-confirmed tuberculosis. Diagn Microbiol Infect Dis 2011;70(3): 324-9. [PubMed]
25. Kobashi Y, Mouri K, Yagi S, Obase Y, Miyashita N, Okimoto N, et al. Clinical utility of the QuantiFERON TB-2G test for elderly patients with active tuberculosis. Chest 2008;133(5):1196-202. [PubMed]
26. Nakamura H, Tateyama M, Tasato D, Teruya H, Chibana K, Tamaki Y, et al. Active tuberculosis in patients undergoing hemodialysis for end-stage renal disease: a 9-year retrospective analysis in a single center. Internal medicine 2009;48(24):2061-7.
27. Stephan C, Wolf T, Goetsch U, Bellinger O, Nisius G, Oremek G, et al. Comparing QuantiFERON-tuberculosis gold, T-SPOT tuberculosis and tuberculin skin test in HIV-infected individuals from a low prevalence tuberculosis country. Aids 2008;22(18):2471-9. [PubMed]
28. Choi JC, Jarlsberg LG, Grinsdale JA, Osmond DH, Higashi J, Hopewell PC, et al. Reduced sensitivity of the QuantiFERON® test in diabetic patients with smear-negative tuberculosis. Int J Tuberc Lung Dis 2015;19(5):582-8. [PubMed]
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Mansourzadeh A, Honarmand Jahromi S, Khoshmirsafa M, Falak R. Comparison of Interferon-Gamma Release and Tuberculin Skin Test for Detection of Latent Tuberculosis Infections in Iranian Elderly Patients. Iran J Med Microbiol. 2017; 11 (2) :17-25
URL: http://ijmm.ir/article-1-587-en.html
Volume 11, Number 2 (May - June 2017) Back to browse issues page
مجله میکروب شناسی پزشکی ایران Iranian Journal of Medical Microbiology
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