Interferon-gamma assays for the diagnosis of tuberculosis infection before using tumour necrosis factor-alpha blockers
Abstract:OBJECTIVES: Patients who receive tumour necrosis factor-alpha (TNF-α) blockers are mostly immunosuppressed. A study was performed to investigate whether an interferon-gamma (IFN-γ) assay could represent an alternative approach to the tuberculin skin test (TST) for the diagnosis of latent tuberculosis infection (LTBI) in these patients.
DESIGN: We prospectively enrolled 106 individuals into the study in two groups. Group 1 consisted of 38 healthy individuals and Group 2 included 68 patients with chronic inflammatory diseases evaluated for LTBI before the use of TNF-α blockers.
RESULTS: Of all participants, nine had indeterminate IFN-γ test results. Agreement between the two tests was poor in both groups (κ values respectively −0.54 and 0.18). In a total of 97 subjects, 10 (10.3%) were positive by the IFN-γ test and 49 (50.5%) by TST.
CONCLUSION: We found poor agreement between TST and the IFN-γ test in our study. Our limited preliminary data should be accepted as a basis for designing future studies that will be helpful for physicians to decide whether the IFN-γ test is more sensitive than the TST test in detecting LTBI before the use of TNF-α blockers.
Document Type: Regular Paper
Affiliations: 1: Hacettepe University Faculty of Medicine Pediatric Pulmonary Diseases Unit, Ankara, Turkey 2: Hacettepe University Faculty of Medicine Rheumatology Unit, Ankara, Turkey 3: Hacettepe University Faculty of Medicine Pediatric Nephrology and Rheumotology Unit, Ankara, Turkey
Publication date: November 1, 2007
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