The Korean journal of internal medicine

The Korean Association of Internal Medicine (대한내과학회)
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Qualitative and quantitative results of interferon-γ release assays for monitoring the response to anti-tuberculosis treatment

  • Park, I-Nae (Department of Internal Medicine, Inje University Seoul Paik Hospital) ;
  • Shim, Tae Sun (Division of Pulmonology and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine)
  • Received : 2016.06.27
  • Accepted : 2016.10.20
  • Published : 2017.03.01
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Abstract

Background/Aims: The usefulness of $interferon-{\gamma}$ release assays (IGRAs) in monitoring to responses to anti-tuberculosis (TB) treatment is controversial. We compared the results of two IGRAs before and after anti-TB treatment in same patients with active TB. Methods: From a retrospective review, we selected patients with active TB who underwent repeated QuantiFERON-TB Gold (QFN-Gold, Cellestis Limited) and T-SPOT.TB (Oxford Immunotec) assays before and after anti-TB treatment with first-line drugs. Both tests were performed prior to the start of anti-TB treatment or within 1 week after the start of anti-TB treatment and after completion of treatment. Results: A total of 33 active TB patients were included in the study. On the QFN-Gold test, at baseline, 23 cases (70%) were early secreted antigenic target 6-kDa protein 6 (ESAT-6) or culture filtrate protein 10 (CFP-10) positive. On the T-SPOT. TB test, at baseline, 31 cases (94%) were ESAT-6 or CFP-10 positive. Most of patients remained both test-positive after anti-TB treatment. Although changes in $interferon-{\gamma}$ release responses over time were highly variable in both tests, there was a mean decline of 27 and 24 spot-forming counts for ESAT-6 and CFP-10, respectively on the T-SPOT.TB test (p < 0.05 for all). Conclusions: Although limited by the small number of patients and a short-term follow-up, there was significant decline in the quantitative result of the T-SPOT. TB test with treatment. However, both commercial IGRAs may not provide evidence regarding the cure of disease in Korea, a country where the prevalence of TB is within the intermediate range.

Keywords

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