scholarly journals Elevated Rates of Indeterminate Results on QuantiFERON®-TB Gold Plus in COVID-19 Patients

2021 ◽  
Author(s):  
Kileen L. Shier
Keyword(s):  
Critically Ill ◽  
Interferon Gamma ◽  
Clinical Microbiology ◽  
Latent Tuberculosis Infection ◽  
Immunosuppressive Agents ◽  
Latent Tuberculosis ◽  
Interferon Γ ◽  
Cytokine Expression ◽  
Tuberculosis Infection ◽  
Interferon Gamma Release Assays

Interferon-gamma release assays are used to screen various patient populations for latent tuberculosis infection. In this issue of the Journal of Clinical Microbiology, Ward et al. (J Clin Microbiol 59:e00811-21, 2021, https://doi.org/10.1128/JCM.00811-21 ) investigated an increased indeterminate rate in the QuantiFERON-TB Gold Plus assay among COVID-19 patients that was independent of immunosuppressive agents and lymphopenia. In their study, COVID-19 patients with indeterminate QuantiFERON-TB Gold Plus results trended toward decreased survival as well as increased serum IL-6 and IL-10 levels, though the differences were not statistically significant. They suggest that this pattern of cytokine expression supports an impairment of Th1, and specifically interferon-γ production, in critically ill COVID-19 patients, as indicated by indeterminate QuantiFERON-TB Gold Plus results. Clinicians should be aware of the increased rate of indeterminate QuantiFERON-TB Gold Plus results in critically ill COVID-19 patients.

scholarly journals Interferon Gamma Release Assays for Latent Tuberculosis: What Are the Sources of Variability?

2016 ◽  
Vol 54 (4) ◽  
pp. 845-850 ◽  
Author(s):  
Niaz Banaei ◽  
Rajiv L. Gaur ◽  
Madhukar Pai
Keyword(s):  
Tuberculin Skin Test ◽  
Skin Test ◽  
Interferon Gamma ◽  
Latent Tuberculosis Infection ◽  
Latent Tuberculosis ◽  
Low Risk ◽  
Tuberculosis Infection ◽  
Serial Testing ◽  
Conversion Rates ◽  
Interferon Gamma Release Assays

Interferon gamma release assays (IGRAs) are blood-based tests intended for diagnosis of latent tuberculosis infection (LTBI). IGRAs offer logistical advantages and are supposed to offer improved specificity over the tuberculin skin test (TST). However, recent serial testing studies of low-risk individuals have revealed higher false conversion rates with IGRAs than with TST. Reproducibility studies have identified various sources of variability that contribute to nonreproducible results. Sources of variability can be broadly classified as preanalytical, analytical, postanalytical, manufacturing, and immunological. In this minireview, we summarize known sources of variability and their impact on IGRA results. We also provide recommendations on how to minimize sources of IGRA variability.

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