scholarly journals Comparison of QuantiFERON-TB Gold In-Tube Test and Tuberculin Skin Test for Identification of LatentMycobacterium tuberculosisInfection in Healthcare Staff and Association Between Positive Test Results and Known Risk Factors for Infection

2009 ◽  
Vol 30 (3) ◽  
pp. 215-221 ◽  
Author(s):  
Paul Vinton ◽  
Seema Mihrshahi ◽  
Paul Johnson ◽  
Grant A. Jenkin ◽  
Damien Jolley ◽  
...  
Keyword(s):  
Risk Factors ◽  
Tuberculin Skin Test ◽  
Skin Test ◽  
Prior History ◽  
Test Results ◽  
Healthcare Staff ◽  
Bcg Vaccination ◽  
Tube Test ◽  
High Prevalence ◽  
Test Result

Objective.We compared a whole-blood interferon-γ release assay (QuantiFERON-TB Gold In-Tube test, hereafter “QFT-in tube test”) with a tuberculin skin test (TST) to determine which test more accurately identified latentMycobacterium tuberculosisinfection in healthcare staff.Methods.A total of 481 hospital staff members were recruited from 5 hospitals in Melbourne, Australia. They provided information about demographic variables and tuberculosis (TB) risk factors (ie, birth or travel in a country with a high prevalence of TB, working in an occupation likely to involve contact withM. tuberculosisor individuals with TB, or being a household contact of an individual with a proven case of pulmonary TB). The QFT-in tube test and the TST were administered in accordance with standardized protocols. Concordance between the test results and positive risk factors was analyzed using theкstatistic, the McNemar test, and logistic regression.Results.A total of 358 participants had both a TST result and a QFT-in tube test result available for comparison. There were fewer positive QFT-in tube test results than positive TST results (6.7% vs. 33.0%;P< .001). Agreement between the tests was poor (71%;к= 0.16). A positive QFT-in tube test result was associated with birth in a country with a high prevalence of TB, the number of years an individual had lived in a country with a high prevalence of TB (ie, the effect of each additional year, treated as a continuous variable), and high-risk occupational contact. A positive TST result was associated with older age, receipt of bacille Calmette-Guérin (BCG) vaccination, and working in an occupation that involved patient contact. Receipt of BCG vaccination was most strongly associated with discordant results in instances in which the TST result was positive and the QFT-in tube test result was negative.Conclusion.In a population of healthcare staff with a low prevalence of TB and a significant rate of BCG vaccination, a positive QFT-in tube test result was associated with the presence of known risk factors for TB exposure, whereas a positive TST result was more strongly associated with a prior history of BCG vaccination.

scholarly journals Screening for latent tuberculosis infection: performance of tuberculin skin test and interferon-γ release assays under real-life conditions

2012 ◽  
Vol 71 (11) ◽  
pp. 1791-1795 ◽  
Author(s):  
S Kleinert ◽  
H-P Tony ◽  
K Krueger ◽  
J Detert ◽  
F Mielke ◽  
...  
Keyword(s):  
Risk Factors ◽  
Tuberculin Skin Test ◽  
Skin Test ◽  
Latent Tuberculosis Infection ◽  
Latent Tuberculosis ◽  
Interferon Γ ◽  
Clinical Risk Factors ◽  
Test Results ◽  
Bcg Vaccination ◽  
Rheumatological Disease

ObjectivesTo characterise optimal screening strategies for latent tuberculosis infection (LTBI) prior to the initiation of anti-tumour necrosis factor therapy.MethodsPatients in 62 German rheumatology centres were evaluated for LTBI. Each patient was screened with a tuberculin skin test (TST) and one form of an interferon-γ release assay (IGRA), either TSPOT.TB (TSPOT) or Quantiferon TB Gold (QFT).ResultsA total of 1529 patients with rheumatological disease were tested with a TST, 844 with TSPOT and 685 with QFT. TST was positive in 11.3% (n=173). The prevalence of LTBI was 8.0% when defined as a positive TST and no previous Bacille Calmette-Guérin (BCG) vaccination and 7.9% when based on a positive IGRA. Combining both estimates increased the prevalence of LTBI to 11.1%. Clinical risk factors for LTBI were found in 122 patients (34 with a history of prior TB, 81 close contacts and 27 with suggestive chest x-ray lesions). A compound risk factor (CRF) was defined as the presence of at least one of these three risk factors. Statistical analyses were conducted to examine the association between CRF and LTBI test outcomes. In multivariate analysis, TST was influenced by CRF (OR 6.2; CI 4.08 to 9.44, p<0.001) and BCG vaccination status (OR 2.9; CI 2.00 to 4.35, p<0.001). QFT and TSPOT were only influenced by CRF (QFT: OR 2.6; CI 1.15 to 5.98, p=0.021; TSPOT: OR 8.7; CI 4.83 to 15.82, p<0.001). ORs and the agreement of TST and IGRA test results varied by rheumatological disease.ConclusionLTBI test results in an individual patient need to be considered in the context of prior BCG vaccination and clinical risk factors. In patient populations with low rates of TB incidence and BCG vaccination, the use of both TST and IGRA may maximise sensitivity in detecting LTBI but may also reduce specificity.

scholarly journals Comparison of a New ESAT-6/CFP-10 Peptide-Based Gamma Interferon Assay and a Tuberculin Skin Test for Tuberculosis Screening in a Moderate-Risk Population

2006 ◽  
Vol 13 (1) ◽  
pp. 53-58 ◽  
Author(s):  
Emaeil Porsa ◽  
Lee Cheng ◽  
Michael M. Seale ◽  
George L. Delclos ◽  
Xin Ma ◽  
...  
Keyword(s):  
African American ◽  
Tuberculin Skin Test ◽  
Skin Test ◽  
The United States ◽  
Gamma Interferon ◽  
Test Results ◽  
Bcg Vaccination ◽  
Ifn Γ ◽  
Foreign Birth ◽  
American Ethnicity

ABSTRACT Screening for latent tuberculosis infection (LTBI) with Mantoux tuberculin skin test (TST) has many limitations, including false-positive results due to exposure to Mycobacterium other than tuberculosis (TB) and BCG vaccination. A total of 474 adult inmates in a county jail were screened for LTBI using TST and a new ESAT-6/CFP-10 peptide-based whole-blood gamma interferon (IFN-γ) assay. LTBI prevalence was 9.0 and 5.4% as determined by TST and IFN-γ assay, respectively. Overall, agreement between test results was 90% (κ = 0.25). Positive TST results were significantly associated with increased age (odds ratio [OR], 1.04; 95% confidence interval [CI], 1.01 to 1.08), African-American ethnicity (OR, 4.97; 95% CI, 1.58 to 15.68), foreign birth (OR, 20.20; 95% CI, 4.21 to 97.02) and prior incarceration (OR, 6.19; 95% CI, 1.48 to 25.95). Positive IFN-γ assay results were significantly associated with African-American ethnicity (OR, 5.58; 95% CI, 1.16 to 26.74). Factors associated with statistically significant discordance between TST and IFN-γ assay results were African-American ethnicity (OR, 0.29; 95% CI, 0.11 to 0.77), foreign birth (OR, 0.23; 95% CI, 0.07-0.80), and prior incarceration (OR, 0.06; 95% CI, 0.01-0.50). Among subjects born in the United States, African-American ethnicity was the only variable significantly associated with positive test results for both TST (OR, 4.26; 95% CI, 1.38 to 13.16) and IFN-γ assay (OR, 5.74; 95% CI, 1.19 to 27.75) and remained associated with statistically significant discordance between TST and IFN-γ assay results. The reactivity of the new IFN-γ assay is unaffected by prior BCG vaccination or serial TSTs but may be diminished in African-Americans. Future longitudinal studies are needed to assess the sensitivity and specificity of this new assay in detecting LTBI.

scholarly journals Prevalence and predictors of positive tuberculin skin test results in a research laboratory

2008 ◽  
Vol 41 (4) ◽  
pp. 416-418 ◽  
Author(s):  
Florian H. Pilsczek ◽  
Stefan H.E. Kaufmann
Keyword(s):  
Tuberculin Skin Test ◽  
Skin Test ◽  
Research Laboratory ◽  
Latent Tuberculosis ◽  
Positive Tuberculin Skin Test ◽  
Active Tuberculosis ◽  
Test Results ◽  
Place Of Birth ◽  
High Prevalence ◽  
History Of

Latent tuberculosis was studied in a research laboratory. A prevalence of positive tuberculin skin test results (> 15mm) of 20% was found and the main predictors were place of birth in a foreign country with high prevalence of tuberculosis and a history of contact with patients with untreated active tuberculosis.

scholarly journals Utility of QuantiFERON®-TB Gold In-Tube Test Compared with Tuberculin Skin Test in Diagnosing Tuberculosis in Indian Children with Malnutrition

2019 ◽  
Vol 37 (3) ◽  
pp. 433-437
Author(s):  
Deepthi Boddu ◽  
Valsan Philip Verghese ◽  
Joy Sarojini Michael ◽  
Anila Chacko ◽  
Visali Jeyaseelan
Keyword(s):  
Tuberculin Skin Test ◽  
Skin Test ◽  
Indian Children ◽  
Tube Test

scholarly journals Predictive Factors for Positive HIV Test Results in a Hospital Setting

2021 ◽  
Vol 16 (3) ◽  
Author(s):  
Sulmaz Ghahramani ◽  
Hassan Joulaei ◽  
Amir Human Hoveidaei ◽  
Mohammad Reza Rajabi ◽  
Kamran Bagheri Lankarani
Keyword(s):  
Risk Factors ◽  
Hospital Admission ◽  
Hiv Testing ◽  
General Hospital ◽  
Hospital Setting ◽  
Hiv Positive ◽  
Control Group ◽  
Test Results ◽  
Hiv Test ◽  
Test Result

Background: Hospital admission for any reason provides the situation for voluntary HIV testing and consultation. Identifying the predictors of positivity may lead to a cost-effective method while enhancing professionalism. Objectives: To find the predictors of HIV-positive test result in a general hospital in Shiraz compared to a control group. Methods: In this case-control study, the records of all patients who received HIV testing upon their hospitalization in a general hospital in Shiraz, south of Iran, from January 2017 to the end of December 2017 were reviewed. For each HIV-positive case, at least one control from the same ward in the hospital with negative HIV test result was randomly selected. Based on the best-fitted model of logistic regression, the probability of positive HIV test results was estimated for each participant according to the risk factors, and a receiver operating characteristic (ROC) curve was drawn. Results: Out of 7333 persons who accepted to be tested, 77 patients tested positive for HIV, of whom 55 (71.4%) were male with the mean age of 41.5 ± 9.5 years. None of the HIV-positive patients were intravenous drug users, nor had they a history of imprisonment. The odds ratio (OR) was 21 for hepatitis-positive patients (hepatitis B and/or C) compared to negative ones, which was seven times higher in opium addicts than non-opium addicts. We developed a model using age, sex, opium addiction, and HBV and HCV status to predict the probability of being positive for HIV with an AUC of 0.853 (95% confidence interval 0.797 to 0.909). Conclusions: Hospital admission could be an appropriate momentum for providing voluntary counseling and testing. Infection with HBV and HCV are important risk factors for HIV infection, and additional testing should be offered, especially to these patients.

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