Identification of Recent Tuberculosis Exposure Using QuantiFERON-TB Gold Plus, a Multicenter Study
Por:
Perez-Recio, S, Pallares, N, Grijota-Camino, MD, Sanchez-Montalva, A, Barcia, L, Campos-Gutierrez, S, Pomar, V, Rabunal-Rey, R, Balcells, ME, Gazel, D, Montiel, N, Vicente, D, Goic-Barisic, I, Schon, T, Paues, J, Marekovic, I, Cacho-Calvo, J, Barac, A, Goletti, D, Garcia-Gasalla, M, Barcala, JM, Tortola, MT, Anibarro, L, Suarez-Toste, I, Moga, E, Gude-Gonzalez, MJ, Naves, R, Karsligil, T, Martin-Penaranda, T, Stevanovic, G, Trigo, M, Rubio, V, Karaoglan, I, Bayram, N, Alcaide, F, Tebe, C, Santin, M
Publicada:
1 dic 2021
Resumen:
We investigated whether the difference of antigen tube 2 (TB2) minus antigen tube 1 (TB1) (TB22TB1) of the QuantiFERON-TB gold plus test, which has been postulated as a surrogate for the CD81 T-cell response, could be useful in identifying recent tuberculosis (TB) exposure. We looked at the interferon gamma (IFN-g) responses and differences in TB2 and TB1 tubes for 686 adults with QFT-plus positive test results. These results were compared among groups with high (368 TB contacts), low (229 patients with immune-mediated inflammatory diseases [IMID]), and indeterminate (89 asylum seekers or people from abroad [ASPFA]) risks of recent TB exposure. A TB2-TB1 value.0.6 IU.ml(-1) was deemed to indicate a true difference between tubes. In the whole cohort, 13.6%, 10.9%, and 11.2% of cases had a TB2>TB1 result in the contact, IMID, and ASPFA groups, respectively (P = 0.591). The adjusted odds ratios (aORs) for an association between a TB2-TB1 result of >0.6 IU.ml(-1) and risk of recent exposure versus contacts were 0.71 (95% confidence interval [CI], 0.31 to 1.61) for the IMID group and 0.86 (95% CI, 0.49 to 1.52) for the ASPFA group. In TB contact subgroups, 11.4%, 15.4%, and 17.7% with close, frequent, and sporadic contact had a TB2>TB1 result (P = 0.362). The aORs versus the close subgroup were 1.29 (95% CI, 0.63 to 2.62) for the frequent subgroup and 1.55 (95% CI, 0.67 to 3.60) for the sporadic subgroup. A TB2-TB1 difference of.0.6 IU.ml(-1) was not associated with increased risk of recent TB exposure, which puts into question the clinical potential as a proxy marker for recently acquired TB infection.
IMPORTANCE Contact tuberculosis tracing is essential to identify recently infected people, who therefore merit preventive treatment. However, there are no diagnostic tests that can determine whether the infection is a result of a recent exposure or not. It has been suggested that by using the QuantiFERON-TB gold plus, an interferon gamma (IFN-gamma) release assay, a difference in IFN-gamma production between the two antigen tubes (TB2 minus TB1) of.0.6 IU.ml(-1) could serve as a proxy marker for recent infection. In this large multinational study, infected individuals could not be classified according to the risk of recent exposure based on differences in IFN- g in TB1 and TB2 tubes that were higher than 0.6 IU.ml(-1). QuantiFERON-TB gold plus is not able to distinguish between recent and remotely acquired tuberculosis infection, and it should not be used for that purpose in contact tuberculosis tracing.
Filiaciones:
Perez-Recio, S:
Bellvitge Univ Hosp, Dept Infect Dis, TB Unit, Bellvitge Biomed Res Inst IDIBELL, Barcelona, Spain
Pallares, N:
Bellvitge Biomed Res Inst IDIBELL, Biostat Unit UBiDi, Barcelona, Spain
Grijota-Camino, MD:
Bellvitge Univ Hosp, Dept Infect Dis, TB Unit, Bellvitge Biomed Res Inst IDIBELL, Barcelona, Spain
Sanchez-Montalva, A:
Vall dHebron Univ Hosp, Dept Infect Dis, PROSICS, Barcelona, Spain
Barcia, L:
Complexo Hosp Univ Pontevedra, Dept Internal Med, TB Unit, Pontevedra, Spain
Campos-Gutierrez, S:
Univ Hosp Canary Isl, Microbiol & Infect Control Serv, Tenerife, Canary Islands, Spain
Pomar, V:
Hosp Santa Creu & Sant Pau, Infect Dis Unit, Dept Internal Med, Barcelona, Spain
Rabunal-Rey, R:
Hosp Lucus Augusti, Dept Internal Med, Infect Dis Unit, Lugo, Spain
Balcells, ME:
Pontificia Univ Catolica Chile, Sch Med, Dept Infect Dis, Santiago, Chile
Gazel, D:
Gaziantep Univ, Dept Med Microbiol, Fac Med, Gaziantep, Turkey
Montiel, N:
Hosp Costa del Sol, Dept Microbiol, Malaga, Spain
Hosp Univ Puerta Mar, Dept Microbiol, Cadiz, Spain
Vicente, D:
Hosp Univ Donostia, Dept Microbiol, San Sebastian, Spain
Goic-Barisic, I:
Univ Hosp Split, Dept Clin Microbiol, Split, Croatia
Univ Split, Sch Med, Split, Croatia
Schon, T:
Linkoping Univ, Kalmar Cty Hosp, Dept Infect Dis, Kalmar, Linkoping, Sweden
Linkoping Univ, Dept Biomed & Clin Sci, Div Infect Dis, Linkoping, Sweden
Paues, J:
Linkoping Univ, Dept Biomed & Clin Sci, Div Infect Dis, Linkoping, Sweden
Marekovic, I:
Univ Hosp Ctr Zagreb, Dept Clin & Mol Microbiol, Zagreb, Croatia
Cacho-Calvo, J:
Getafe Univ Hosp, Dept Microbiol, Madrid, Spain
Barac, A:
Clin Ctr Serbia, Clin Infect & Trop Dis, Belgrade, Serbia
Univ Belgrade, Fac Med, Belgrade, Serbia
Goletti, D:
Ist Nazl Malattie Infett Lazzaro Spallanzani IRCC, Rome, Italy
Garcia-Gasalla, M:
Hosp Univ Son Llatzer IdISBa, Dept Internal Med, Infect Dis Unit, Palma De Mallorca, Illes Balears, Spain
Hosp Univ Son Espases IdISBa, Dept Internal Med, Infect Dis Unit, Palma De Mallorca, Illes Balears, Spain
Barcala, JM:
Hosp Univ Jerez, Infect Dis Unit, Cadiz, Spain
Tortola, MT:
Vall dHebron Univ Hosp, Dept Microbiol, Barcelona, Spain
Univ Autonoma Barcelona, Dept Genet & Microbiol, Barcelona, Spain
Anibarro, L:
Complexo Hosp Univ Pontevedra, Dept Internal Med, TB Unit, Pontevedra, Spain
Suarez-Toste, I:
Univ Hosp Canary Isl, Pneumol Serv, Tenerife, Canary Islands, Spain
Moga, E:
Hosp Santa Creu & Sant Pau, Dept Immunol, Biomed Res Inst St Pau IIB St Pau, Barcelona, Spain
Gude-Gonzalez, MJ:
Hosp Lucus Augusti, Dept Microbiol, Lugo, Spain
Naves, R:
Univ Chile, Fac Med, Inst Biomed Sci, Program Immunol, Santiago, Chile
Karsligil, T:
Gaziantep Univ, Dept Med Microbiol, Fac Med, Gaziantep, Turkey
Martin-Penaranda, T:
Hosp Univ Donostia, Dept Microbiol, San Sebastian, Spain
Stevanovic, G:
Clin Ctr Serbia, Clin Infect & Trop Dis, Belgrade, Serbia
Univ Belgrade, Fac Med, Belgrade, Serbia
Trigo, M:
Complexo Hosp Univ Pontevedra, Microbiol Dept, Pontevedra, Spain
Rubio, V:
Hosp Santa Creu & Sant Pau, Infect Dis Unit, Dept Internal Med, Barcelona, Spain
Hosp Municipal Badalona, Dept Internal Med, Barcelona, Spain
Karaoglan, I:
Gaziantep Univ, Dept Infect Dis & Clin Microbiol, Fac Med, Gaziantep, Turkey
Bayram, N:
Gaziantep Univ, Dept Pulm Dis, Fac Med, Gaziantep, Turkey
Alcaide, F:
Bellvitge Univ Hosp, Dept Microbiol, Bellvitge Biomed Res Inst IDIBELL, Barcelona, Spain
Univ Barcelona, Dept Pathol & Expt Therapy, Barcelona, Spain
Tebe, C:
Bellvitge Biomed Res Inst IDIBELL, Biostat Unit UBiDi, Barcelona, Spain
Santin, M:
Bellvitge Univ Hosp, Dept Infect Dis, TB Unit, Bellvitge Biomed Res Inst IDIBELL, Barcelona, Spain
Univ Barcelona, Dept Clin Sci, Barcelona, Spain
hybrid, Green Published
|