Negative Tuberculin Skin Test and Prediction of Reversion of QuantiFERON Interferon Gamma Release Assay in US Healthcare Workers

2016 ◽  
Vol 37 (4) ◽  
pp. 478-482 ◽  
Author(s):  
Wendy Thanassi ◽  
Art Noda ◽  
Beatriz Hernandez ◽  
Leah Friedman ◽  
Susan Dorman ◽  
...  
Keyword(s):  
Tuberculin Skin Test ◽  
Skin Test ◽  
Interferon Gamma ◽  
Healthcare Workers ◽  
Low Risk ◽  
Infect Control Hosp ◽  
Skin Tests ◽  
Interferon Gamma Release Assay ◽  
Negative Tuberculin Skin Test ◽  
Release Assay

QuantiFERON tuberculosis tests (QFT) reverted in (612) 77% of 1,094 low-risk healthcare workers (HCW) testing less than 1.16 IU/mL. Of HCW testing greater than 1.1 IU/mL, 33 (59%) of 56 with negative tuberculin skin tests (TST) reverted vs 8 (6%) of 125 with positive TSTs. Retesting low-risk QFT-positive and TST-negative HCW is prudent.Infect. Control Hosp. Epidemiol. 2016;37(4):478–482

scholarly journals Performance of Tuberculin Skin Test Measured against Interferon Gamma Release Assay as Reference Standard in Children

2014 ◽  
Vol 2014 ◽  
pp. 1-8 ◽  
Author(s):  
Michael Eisenhut ◽  
Katy Fidler
Keyword(s):  
Tuberculin Skin Test ◽  
Skin Test ◽  
Interferon Gamma ◽  
Cochrane Library ◽  
Interferon Gamma Release Assay ◽  
Younger Age ◽  
Geographical Latitude ◽  
Release Assay ◽  
The Cochrane Library ◽  
Higher Sensitivity

Objectives. International guidelines differ in the threshold of tuberculin skin test (TST) induration regarded as indicatingMycobacterium (M.) tuberculosisinfection. Interferon gamma release assay (IGRA) results were used as reference to assess performance of TST induration thresholds for detection ofM. tuberculosisinfection in children.Design. Systematic review which included studies containing data on TST, IGRA, and Bacillus Calmette-Guérin (BCG) status in children. Data bases searched were PubMed, EMBASE, and the Cochrane library. Specificities and sensitivities were calculated for TST thresholds 5, 10, and 15 mm and correlated with age and geographical latitude.Results. Eleven studies with 2796 children were included. For BCG immunised children diameters of 5, 10, and 15 mm had median sensitivities of 87, 70, and 75% and specificities of 67, 93, and 90%, respectively. In non-BCG immunised children median sensitivities were 94, 95, and 83% and specificities 91, 95, and 97%. At the 10 mm threshold age correlated negatively with sensitivity of TST (r=-0.65,P=0.04) and latitude correlated positively (r=0.71,P=0.02).Conclusions. For the 10 mm threshold the sensitivity of the TST is lower in BCG immunised children. Younger age and higher geographical latitude were associated with higher sensitivity of the TST.

scholarly journals Frequency of indeterminate results from an interferon-gamma release assay among HIV-infected individuals

2017 ◽  
Vol 43 (3) ◽  
pp. 215-218 ◽  
Author(s):  
Sandra Maria do Valle Leone de Oliveira ◽  
Anete Trajman ◽  
Anamaria Mello Miranda Paniago ◽  
Ana Rita Coimbra Motta-Castro ◽  
Antonio Ruffino-Netto ◽  
...  
Keyword(s):  
Tuberculin Skin Test ◽  
Skin Test ◽  
Interferon Gamma ◽  
Kappa Statistic ◽  
Multivariate Logistic Regression Model ◽  
Interferon Gamma Release Assay ◽  
People Living With Hiv ◽  
Release Assay ◽  
The Difference ◽  
Living With Hiv

ABSTRACT Objective: To evaluate the frequency of and factors associated with indeterminate interferon-gamma release assay (IGRA) results in people living with HIV/AIDS (PLWHA). Methods: We tested 81 PLWHA in the central-west region of Brazil, using the tuberculin skin test and an IGRA. Information on sociodemographic and clinical variables was gathered through the use of questionnaires and from medical records. The association of those variables with indeterminate results was analyzed by calculating the adjusted ORs in a multivariate logistic regression model. Concordance was evaluated by determining the kappa statistic. Results: Among the 81 patients evaluated, the tuberculin skin test results were positive in 18 (22.2%) of the patients, and the IGRA results were positive in 10 (12.3%), with a kappa of 0.62. The IGRA results were indeterminate in 22 (27.1%) of the patients (95% CI: 17.8-38.1%). The odds of obtaining indeterminate results were significantly higher in smokers (adjusted OR = 6.0; 95% CI: 1.4-26.7) and in samples stored for less than 35 days (adjusted OR = 14.0; 95% CI: 3.1-64.2). Patients with advanced immunosuppression (CD4+ T-cell count < 200 cells/mm3) were at a higher risk for indeterminate results (OR adjusted for smoking and inadequate duration of sample storage = 4.7; 95% CI: 0.91-24.0), although the difference was not significant. Conclusions: The high prevalence of indeterminate results can be a major limitation for the routine use of IGRAs in PLWHA. The need to repeat the test increases its costs and should be taken into account in cost-effectiveness studies. The processing of samples can significantly alter the results.

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