Chest
Original ResearchLatent TuberculosisThe Effect of Previous Tuberculin Skin Test on the Follow-up Examination of Whole-Blood Interferon-γ Assay in the Screening for Latent Tuberculosis Infection
Section snippets
Study Design and Setting
A cross-sectional study was conducted from August 2006 until December 2006 at Chung-Ang University Hospital and Chung-Ang University Yong San Hospital in South Korea. The study protocol was approved by the Institutional Review Board at Yong San Hospital, Seoul, South Korea (No. 2006-012-07-1). At these hospitals, approximately 200 cases of smear-positive or culture-positive patients are treated for TB each year.
Participants
This study was designed to recruit HCWs who were directly involved in the clinical
Demographic Characteristics of HCWs
Eighty-four HCWs were included in this study. The median age of the HCWs was 28 years (age range, 23 to 45 years), and 75 HCWs (92%) were women. All participants had a history of BCG vaccination. The median working duration was 26 months (range, 12 to 240 months).
TST Results
Valid TST results were available in 82 individuals because two participants refused to take the TST after the IFN-γ assay. Ten individuals had undergone the TST 3 years before, but the remainder had no history of undergoing the TST
Discussion
The major findings of this study were as follows: (1) the IFN-γ level was increased significantly among TST-positive individuals when the IFN-γ assay was performed 2 to 4 weeks after the TST; (2) the IFN-γ level was not influenced by the TST among TST-negative individuals; (3) the percentage of concordant results between the TST and the IFN-γ assay was low (67.5%), with the κ coefficients indicative of poor agreement (0.31). Concordance between the results of the IFN-γ assay and the TST has
Acknowledgment
We thank the numerous individuals who volunteered to participate in this study. We also acknowledge the insightful contributions of Eun Ju Jun, MD, and Jae Woo Jung, MD.
References (29)
- et al.
Comparison of T-cell-based assay with tuberculin skin test for diagnosis of Mycobacterium tuberculosis infection in a school tuberculosis outbreak
Lancet
(2003) - et al.
Palpation vs pen method for the measurement of skin tuberculin reaction (Mantoux test)
Chest
(1991) - et al.
Comparison of two commercial interferon-gamma assays for diagnosing Mycobacterium tuberculosis infection
Eur Respir J
(2006) - et al.
Comparison of a whole-blood interferon gamma assay with tuberculin skin testing for detecting latent Mycobacterium tuberculosis infection
JAMA
(2001) - et al.
Clinical practice: latent tuberculosis infection
N Engl J Med
(2002) World Health Organization guidelines for prevention of tuberculosis in healthcare facilities in countries with limited resources (measures for prevention of tuberculosis)
Med Pregl
(2004)- et al.
A sandwich enzyme immunoassay for bovine interferon-gamma and its use for the detection of tuberculosis in cattle
Aust Vet J
(1990) - et al.
Comparison of tuberculin skin test and new specific blood test in tuberculosis contacts
Am J Respir Crit Care Med
(2004) Review: commercial interferon-gamma release assays have high specificity but suboptimal sensitivity for detecting latent TB
ACP J Club
(2007)- et al.
Serial testing of health care workers for tuberculosis using interferon-gamma assay
Am J Respir Crit Care Med
(2006)
Tuberculosis: clinical diagnosis and management of tuberculosis, and measures for its prevention and control: clinical guideline 33
Repeated tuberculin testing does not induce false positive ELISPOT results
Thorax
Mycobacterium tuberculosis infection in health care workers in rural India: comparison of a whole-blood interferon gamma assay with tuberculin skin testing
JAMA
Comparison of an interferon-gamma release assay with tuberculin skin testing in HIV-infected individuals
Am J Respir Crit Care Med
Cited by (64)
Latent tuberculosis infection - Revisiting and revising concepts
2015, TuberculosisIncomplete restoration of Mycobacterium tuberculosis-specific-CD4 T cell responses despite antiretroviral therapy
2014, Journal of InfectionCitation Excerpt :Mean PPD-Sp-CD4 T cells (as % of CD4 T cells) increased in patients not classified as TB-sensitised at baseline. There is evidence from the literature that boosting of IGRA responses 1–4 weeks after TST occurs in a small proportion of patients.38–41 The boosting effect from the TST administered at baseline may have accounted for some of the increase in the frequency of PPD-Sp-CD4 T cells.
Low secondary attack rate after prolonged exposure to sputum smear positive miliary tuberculosis in a neonatal unit
2022, Antimicrobial Resistance and Infection ControlThe Tuberculin Skin Test the IFN-γ Release Assays
2021, Tuberculosis in Clinical PracticeScreening of healthcare workers for latent tuberculosis infection in the low tuberculosis burden country: QuantiFERON-TB gold in tube test or tuberculin skin test?
2019, Archives of Environmental and Occupational Health
This Research was supported by the Chung-Ang University Research Grants in 2007.
The authors have reported to the ACCP that no significant conflicts of interest exist with any companies/organizations whose products or services may be discussed in this article.
Reproduction of this article is prohibited without written permission from the American College of chest Physicians (www.chestjournal.org/misc/rerints.shtml).