High Rate of Negative Results of Tuberculin and QuantiFERON Tests Among Individuals With a History of Positive Skin Test Results
- 1 May 2006
- journal article
- research article
- Published by Cambridge University Press (CUP) in Infection Control & Hospital Epidemiology
- Vol. 27 (5), 436-441
- https://doi.org/10.1086/503690
Abstract
To evaluate individuals at high risk for tuberculosis exposure who had a history of a positive tuberculin skin test (TST) result in order to determine the prevalence of unsuspected negative TST results. To confirm these findings with the QuantiFERON-TB test (QFT), an in vitro whole-blood assay that measures tuberculin-induced secretion of interferon-γ. This survey was conducted from November 2001 through December 2003 at 3 sites where TST screening is regularly done. Detailed histories and reviews of medical records were performed. TSTs were placed and read by 2 experienced healthcare workers, and blood was drawn for QFT. Any subject with a negative result of an initial TST during the study (induration diameter, P<.001). Of 31 subjects who completed the TST protocol and the QFT protocol, 8 (25.8%; 95% CI, 10.4%-41.2%) were confirmed negative (P<.005). A significant proportion of subjects with positive results of a previous TST were TST negative in this study, and a subset of these were confirmed negative. These individuals' TST status may have reverted or may never have been positive. It will be important in future studies to determine whether such individuals lack immunity to tuberculosis and whether they should be considered for reentry into tuberculosis screening programs.Keywords
This publication has 31 references indexed in Scilit:
- Spotting latent infection: the path to better tuberculosis controlThorax, 2003
- Utility of Dual Skin Tests to Evaluate Tuberculin Skin Test Reactions of 10 to 14 mm in Healthcare WorkersInfection Control & Hospital Epidemiology, 2003
- How Good Is the Tuberculin Skin Test?Infection Control & Hospital Epidemiology, 2003
- Whole‐blood Interferon‐γ Release Assay Versus the TST: Newer Not BetterClinical Infectious Diseases, 2003
- Memory T cells and vaccinesVaccine, 2003
- Evaluation of a Whole‐Blood Interferon‐γ Release Assay for the Detection ofMycobacterium tuberculosisInfection in 2 Study PopulationsClinical Infectious Diseases, 2002
- Editorial Commentary: Is the In Vitro Interferon‐γ Release Assay an Adequate Replacement for the Tuberculin Skin Test?Clinical Infectious Diseases, 2002
- The Immune Response in Human Tuberculosis—Implications for Tuberculosis ControlThe Journal of Infectious Diseases, 1997
- Tuberculin skin testing and the health care worker: Lessons of the prophit surveyTubercle and Lung Disease, 1996
- A 19-Year Follow-up of Tuberculin ReactorsChest, 1991