Risk Factors Associated with Positive QuantiFERON-TB Gold In-Tube and Tuberculin Skin Tests Results in Zambia and South Africa
Open Access
- 4 April 2011
- journal article
- research article
- Published by Public Library of Science (PLoS) in PLOS ONE
- Vol. 6 (4), e18206
- https://doi.org/10.1371/journal.pone.0018206
Abstract
The utility of T-cell based interferon-gamma release assays for the diagnosis of latent tuberculosis infection remains unclear in settings with a high burden of tuberculosis. To determine risk factors associated with positive QuantiFERON-TB Gold In-Tube (QFT-GIT) and tuberculin skin test (TST) results and the level of agreement between the tests; to explore the hypotheses that positivity in QFT-GIT is more related to recent infection and less affected by HIV than the TST. Adult household contacts of tuberculosis patients were invited to participate in a cross-sectional study across 24 communities in Zambia and South Africa. HIV, QFT-GIT and TST tests were done. A questionnaire was used to assess risk factors. A total of 2,220 contacts were seen. 1,803 individuals had interpretable results for both tests, 1,147 (63.6%) were QFT-GIT positive while 725 (40.2%) were TST positive. Agreement between the tests was low (kappa = 0.24). QFT-GIT and TST results were associated with increasing age (adjusted OR [aOR] for each 10 year increase for QFT-GIT 1.15; 95% CI: 1.06–1.25, and for TST aOR: 1.10; 95% CI 1.01–1.20). HIV positivity was less common among those with positive results on QFT-GIT (aOR: 0.51; 95% CI: 0.39–0.67) and TST (aOR: 0.61; 95% CI: 0.46–0.82). Smear positivity of the index case was associated with QFT-GIT (aOR: 1.25; 95% CI: 0.90–1.74) and TST (aOR: 1.39; 95% CI: 0.98–1.98) results. We found little evidence in our data to support our hypotheses. QFT-GIT may not be more sensitive than the TST to detect risk factors associated with tuberculous infection. We found little evidence to support the hypotheses that positivity in QFT-GIT is more related to recent infection and less affected by HIV than the TST.Keywords
This publication has 41 references indexed in Scilit:
- Guidelines for conducting tuberculin skin test surveys in high-prevalence countries.2011
- T-cell interferon-γ release assays for the rapid immunodiagnosis of tuberculosis: clinical utility in high-burden vs. low-burden settingsCurrent Opinion in Pulmonary Medicine, 2009
- LTBI: latent tuberculosis infection or lasting immune responses to M. tuberculosis? A TBNET consensus statementEuropean Respiratory Journal, 2009
- The Effects of HIV on the Sensitivity of a Whole Blood IFN-γ Release Assay in Zambian Adults with Active TuberculosisPLOS ONE, 2008
- New tools and emerging technologies for the diagnosis of tuberculosis: Part I. Latent tuberculosisExpert Review of Molecular Diagnostics, 2006
- Mycobacterium tuberculosis Infection in Health Care Workers in Rural IndiaPublished by American Medical Association (AMA) ,2005
- Proportion of tuberculosis transmission that takes place in households in a high-incidence areaThe Lancet, 2004
- Adult-to-child transmission of tuberculosis: household or community contact?2003
- Targeted tuberculin testing and treatment of latent tuberculosis infection. American Thoracic Society.2000
- Impact of social interactions in the community on the transmission of tuberculosis in a high incidence areaThorax, 1999