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Free Content Contact tracing using a new T-cell-based test: better correlation with tuberculosis exposure than the tuberculin skin test

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Abstract:

SETTING: Residential institution for alcoholics in Switzerland.

OBJECTIVE: To compare the results of the tuberculin skin test (TST) and the new T-cell-based test for tuberculosis infection (T-SPOT™.TB) in subjects exposed to a case of smear-positive pulmonary TB (PTB).

DESIGN: After the notification of smear-positive PTB in a resident of an institution for alcoholics, contacts underwent TST and determination of Mycobacterium tuberculosis specific T-cells in blood by T-SPOT.TB. Results were analysed according to age, history of BCG vaccination, and level of exposure to the index case.

RESULTS: There was no correlation between the level of exposure and the TST results, but the T-SPOT.TB results were significantly correlated with the level of exposure (P = 0.029, OR 5.00, 95%CI 1.05–23.86). Contacts who had been previously BCG-vaccinated were significantly more likely to have a positive TST than unvaccinated contacts (52% vs. 0%, P = 0.0003), but there was no influence of prior BCG vaccination on T-SPOT.TB results.

CONCLUSIONS: T-SPOT.TB test results correlated better than TST with level of exposure to M. tuberculosis and were not confounded by prior BCG vaccination. This test allows better selection of contacts who should receive treatment for latent TB infection.

Keywords: ELISPOT; IFN-γ release; contact tracing; tuberculin skin test; tuberculosis

Document Type: Regular Paper

Affiliations: 1: TB Dispensary, University Medical Policlinic, Lausanne, Switzerland 2: BBR-LTC Laboratories, Lausanne, Switzerland 3: Fondation ‘Les Oliviers’, Le Mont-sur-Lausanne, Switzerland 4: Oxford Immunotec, Oxford, United Kingdom

Publication date: 2005-11-01

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  • The International Journal of Tuberculosis and Lung Disease publishes articles on all aspects of lung health, including public health-related issues such as training programmes, cost-benefit analysis, legislation, epidemiology, intervention studies and health systems research. The IJTLD is dedicated to the continuing education of physicians and health personnel and the dissemination of information on tuberculosis and lung health world-wide.

    Certain IJTLD articles are selected for translation into French, Spanish, Chinese or Russian. They are available on the Union website

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