Browse > Article

Comparison of the Diagnostic Usefulness of Two Whole-Blood Interferon-Gamma Assays for Extrapulmonary Tuberculosis  

Han, Song-Yee (Department of Internal Medicine, Dong-A University College of Medicine)
Lee, Hyuck (Department of Internal Medicine, Dong-A University College of Medicine)
Jung, Dong-Sik (Department of Internal Medicine, Dong-A University College of Medicine)
Kim, Kyeong-Hee (Department of Laboratory Medicine, Dong-A University College of Medicine)
Woo, Su-Mi (Department of Internal Medicine, Dong-A University College of Medicine)
Park, So-Young (Department of Internal Medicine, Dong-A University College of Medicine)
Seo, Jeong-Min (Department of Internal Medicine, Dong-A University College of Medicine)
Jung, Jin-Kyu (Department of Internal Medicine, Dong-A University College of Medicine)
Yoon, Neul-Bom (Department of Internal Medicine, Dong-A University College of Medicine)
Lee, Sung-Woo (Department of Internal Medicine, Dong-A University College of Medicine)
Publication Information
The Korean Journal of Medicine / v.81, no.4, 2011 , pp. 478-486 More about this Journal
Abstract
Background/Aims: The QuantiFERON-TB Gold (QFT-G) and QuantiFERON-TB Gold in tube (QFT-IT) assays have been studied primarily for the use of diagnosing active pulmonary tuberculosis (TB) or latent TB. The clinical usefulness of these assays for the detection of active extrapulmonary (EP) TB has not been fully defined. The aim of this study was to compare the diagnostic value of these two interferon-gamma assays for EP-TB. Methods: From June 2007 to August 2010, we evaluated the usefulness of QFT-G (n = 56) and QFT-IT (n = 48) in patients (n = 104) with suspected EP-TB. The diagnostic sensitivity, specificity, postive predictive value (PPV), and negative predictive value (NPV) of QFT-G and QFT-IT, and the cut-off value of QFT-IT were analyzed. Results: EP-TB was diagnosed in 55 (53%) patients. The overall sensitivity, specificity, PPV, and NPV of the QFT-IT assay were 96%, 42%, 62%, and 91%, respectively, and those of the QFT-G test were 81%, 52%, 68%, and 68%, respectively. In subgroup analyses according to infection site, the sensitivity and NPV of QFT-IT were higher than those of QFT-G. Analysis confirmed that the manufacturer's recommended test cut-off value fell within our cut-off value range (0.30-0.45 IU/mL; 95.8% sensitivity, 41.7% specificity). Conclusions: The QFT-IT assay showed superior sensitivity and NPV, and equivalent specificity, as comparison with the QFT-G test for the detection of Mycobacterium tuberculosis infection. The logistic benefits of the QFT-IT test format should facilitate the diagnosis of EP-TB.
Keywords
Diagnosis; Interferon gamma; Lymphadenitis; Spondylitis; Tuberculosis;
Citations & Related Records
Times Cited By KSCI : 1  (Citation Analysis)
연도 인용수 순위
1 Annual report on the notified tuberculosis patients in Korea [Internet]. Seoul: Korea Center for Disease Control and Prevention, Korean Institute of Tuberculosis, c2009 [cited 2009 Sep 30]. Available from: http://tbnet.cdc.go.kr.
2 Pai M, Riley LW, Colford JM Jr. Interferon-gamma assays in the immunodiagnosis of tuberculosis: a systematic review. Lancet Infect Dis 2004;4:761-776.   DOI   ScienceOn
3 Kim EY, Lim JE, Jung JY, et al. Performance of the tuberculin skin test and interferon-gamma release assay for detection of tuberculosis infection in immunocompromised patients in a BCG-vaccinated population. BMC Infect Dis 2009;9:207.   DOI   ScienceOn
4 Mazurek GH, LoBue PA, Daley CL, et al. Comparison of a whole-blood interferon gamma assay with tuberculin skin testing for detecting latent Mycobacterium tuberculosis infection. JAMA 2001;286:1740-1747.   DOI   ScienceOn
5 Choi SM, Kwon EY, Kee SY, et al. Accuracy of a new commercial enzyme-linked immunospot assay (T SPOT-TB) for diagnosis of tuberculosis in immunocompromised patients. Korean J Med 2007;73 Suppl:S334.
6 Ruhwald M, Bjerregaard-Andersen M, Rabna P, Kofoed K, Eugen-Olsen J, Ravn P. CXCL10/IP-10 release is induced by incubation of whole blood from tuberculosis patients with ESAT-6, CFP10 and TB7.7. Microbes and Infection 2007;9:806-812, http://dx.doi.org/10.1016/j.micinf.2007.02.021.   DOI   ScienceOn
7 Nishimura T, Hasegawa N, Mori M, Takebayashi T, Harada N, Higuchi K. Accuracy of an interferon-gamma release assay to detect active pulmonary and extra-pulmonary tuberculosis. Int J Tuberc Lung Dis 2008;12:269-274.
8 Dewan PK, Grinsdale J, Kawamura LM. Low sensitivity of a whole-blood interferon-gamma release assay for detection of active tuberculosis. Clin Infect Dis 2007;44:69-73.   DOI   ScienceOn
9 Song KH, Jeon JH, Park WB, et al. Usefulness of the whole-blood interferon-gamma release assay for diagnosis of extrapulmonary tuberculosis. Diagn Microbiol Infect Dis 2009;63:182-187.   DOI   ScienceOn
10 Lee HM, Cho SG, Kang HK, et al. The usefulness of whole-blood interferon-gamma release assay for the diagnosis of extrapulmonary tuberculosis. Tuberc Respir Dis 2009;67:331-337, http://dx.doi.org/10.4046/trd.2009.67.4.331.   DOI   ScienceOn
11 Kim SH, Song KH, Choi SJ, et al. Diagnostic usefulness of a T-cell-based assay for extrapulmonary tuberculosis in immunocompromised patients. Am J Med 2009;122:189-195.   DOI   ScienceOn
12 Harada N, Higuchi K, Yoshiyama T, et al. Comparison of the sensitivity and specificity of two whole blood interferon-gamma assays for M. tuberculosis infection. J Infect 2008;56:348-353.   DOI   ScienceOn