Risk Factors Associated with Positive QuantiFERON-TB Gold In-Tube and Tuberculin Skin Tests Results in Zambia and South Africa


Shanaube, K; Hargreaves, J; Fielding, K; Schaap, A; Lawrence, KA; Hensen, B; Sismanidis, C; Menezes, A; Beyers, N; Ayles, H; Godfrey-Faussett, P; (2011) Risk Factors Associated with Positive QuantiFERON-TB Gold In-Tube and Tuberculin Skin Tests Results in Zambia and South Africa. PLoS One, 6 (4). e18206. ISSN 1932-6203 DOI: https://doi.org/10.1371/journal.pone.0018206

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Abstract

INTRODUCTION: 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.<br/> OBJECTIVES: 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.<br/> METHODS: 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.<br/> RESULTS: 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.<br/> CONCLUSION: 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.<br/>

Item Type: Article
Keywords: BLOOD INTERFERON-GAMMA, HEALTH-CARE WORKERS, HIGH-INCIDENCE AREA, CELL-BASED ASSAY, LATENT TUBERCULOSIS, RELEASE ASSAYS, INFECTION, DIAGNOSIS, TRANSMISSION, HIV
Faculty and Department: Faculty of Infectious and Tropical Diseases > Dept of Clinical Research
Faculty of Epidemiology and Population Health > Dept of Infectious Disease Epidemiology
Faculty of Public Health and Policy > Dept of Social and Environmental Health Research
Faculty of Epidemiology and Population Health > Dept of Population Health (2012- )
Research Centre: Centre for Evaluation
TB Centre
Tropical Epidemiology Group
Population Studies Group
PubMed ID: 21483746
Web of Science ID: 289058700013
URI: http://researchonline.lshtm.ac.uk/id/eprint/809

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