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

被引：20

作者：

de Souza, Fernanda Mattos ^{[1
,2
]}

do Prado, Thiago Nascimento ^{[1
,2
]}

Pinheiro, Jair dos Santos ^{[6
]}

Peres, Renata Lyrio ^{[1
,2
]}

Lacerda, Thamy Carvalho ^{[1
,3
]}

Loureiro, Rafaela Borge ^{[1
,7
]}

Carvalho, Jose Americo ^{[4
]}

Fregona, Geisa ^{[1
,3
,4
]}

Dias, Elias Santos ^{[1
,8
]}

Cosme, Lorrayne Beliqui ^{[1
,8
]}

Rodrigues, Rodrigo Ribeiro ^{[2
]}

Riley, Lee Wood ^{[5
]}

Noia Maciel, Ethel Leonor ^{[1
,3
]}

机构：

[1] Univ Fed Espirito Santo, Lab Epidemiol, Vitoria, ES, Brazil

[2] Univ Fed Espirito Santo, Nucleo Doencas Infecciosas, Vitoria, ES, Brazil

[3] Univ Fed Espirito Santo, Programa Posgrad Saude Colet, Vitoria, ES, Brazil

[4] Univ Fed Espirito Santo, Hosp Univ Cassiano Antonio Moraes, Programa Controle TB, Vitoria, ES, Brazil

[5] Univ Calif Berkeley, Sch Publ Hlth, Div Infect Dis & Vaccinol, Berkeley, CA 94720 USA

[6] Secretaria Municipal Saude, Nucleo Controle TB, Manaus, Amazonas, Brazil

[7] Univ Estado Rio de Janeiro, Inst Social Med, Dept Epidemiol, BR-20550011 Rio De Janeiro, Brazil

[8] Univ Fed Espirito Santo, Vitoria, ES, Brazil

来源：

PLOS ONE | 2014年 / 9卷 / 08期

关键词：

QUANTIFERON-TB-GOLD; HOUSEHOLD CONTACTS; TEST POSITIVITY; TUBE ASSAY; RISK; CONVERSIONS; DISCORDANCE; PREDICTORS; DIAGNOSIS; DISEASE;

D O I：

10.1371/journal.pone.0102773

中图分类号：

O [数理科学和化学]; P [天文学、地球科学]; Q [生物科学]; N [自然科学总论];

学科分类号：

07 ; 0710 ; 09 ;

摘要：

Background: An interferon-gamma 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. Methods: 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. Results: 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 TST2/QFT2 group, risk factors for discordance in the TST+/QFT2 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+/QFT2 group. No statistically significant associations were found among the TST2/QFT+ discordant group with either TST cut-off value. Conclusions: 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.

引用

页数：14

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