Comparison of Mantoux skin test with three generations of a whole blood IFN-γ assay for tuberculosis infection
Abstract:SETTING: A rural town in South Africa.
OBJECTIVE: To compare the performance of QuantiFERON assays with the tuberculin skin test (TST) for identifying latent tuberculosis infection (LTBI) in a high TB burden community.
DESIGN: In a cross-sectional study in healthy adults, we applied the TST and took blood for the three generations of QuantiFERON assays.
RESULTS: Of 358 participants whose results were analysed, 291 (81%) had a TST result of ≥10 mm induration, and 187 (52%) ≥15 mm. QuantiFERON-TB was positive in 215 (60%), QuantiFERON-TB Gold in 137 (38%), and QuantiFERON-TB Gold (In-Tube method) in 201 (56%). There was poor agreement between TST and QuantiFERON tests, and between the different generations of QuantiFERON tests (κ = 0.12–0.50). Of the subset with TST indurations ≥15 mm, 30–56% had negative QuantiFERON tests. However, positive QuantiFERON tests were associated with males, who have a higher incidence of TB in this area.
CONCLUSION: We showed poor agreement between TST and the different QuantiFERON tests in diagnosing LTBI. The surprising discordance between the QuantiFERON TB Gold and QuantiFERON TB Gold (In-Tube method) tests needs to be investigated further.
Document Type: Regular Paper
Affiliations: 1: South African Tuberculosis Vaccine Initiative, Institute of Infectious Disease and Molecular Medicine, Cape Town, South Africa; and School of Child and Adolescent Health, Cape Town, South Africa 2: School of Child and Adolescent Health, University of Cape Town, Cape Town, South Africa 3: Department of Statistical Sciences, University of Cape Town, Cape Town, South Africa 4: Aeras Global Tuberculosis Vaccine Foundation, Bethesda, Maryland, USA
Publication date: March 1, 2006
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