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Interferon-gamma release assays during follow-up of tuberculin skin test-positive contacts

Authors: Franken, W. P. J.1; Arend, S. M.1; Thijsen, S. F. T.2; Bouwman, J. J. M.2; Koster, B. F. P. J.3; van Dissel, J. T.1; Bossink, A. W. J.4

Source: The International Journal of Tuberculosis and Lung Disease, Volume 12, Number 11, November 2008 , pp. 1286-1294(9)

Publisher: International Union Against Tuberculosis and Lung Disease

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Abstract:

SETTING: Following a large-scale contact investigation, individuals with a positive tuberculin skin test (TST) result were offered preventive tuberculosis treatment.

OBJECTIVE: To investigate the effect of isoniazid (INH) treatment and the effect of time on interferon gamma release assay (IGRA) results during follow-up.

DESIGN: TST-positive subjects (n = 122) detected during the large-scale contact investigation were included in the study. Blood was obtained every 6 months over 2 years to perform both tests.

RESULTS: Preventive INH treatment was completed by 36 of the 122 (29.5%) subjects, 71 (58.2%) were followed up with 6-monthly X-ray screening and 15 (12.3%) did not complete INH treatment. The overall percentage of individuals with a positive result remained stable during the 2 years, at approximately 45–50%, but individual responses varied over time. The majority of initially low IGRA results remained below the cut-off value, initially high IGRA results remained positive, while initially intermediate IGRA results were followed by more dynamic patterns.

CONCLUSION: This study showed a highly variable pattern of IGRA responses over time and suggests limited value for their use during follow-up of latently infected individuals. However, the significance of different kinetic patterns observed among subjects with intermediate initial IGRA results warrants further study.

Keywords: QuantiFERON TB Gold In-Tube; T-SPOT.TB; follow-up; latent tuberculosis infection

Document Type: Regular Paper

Affiliations: 1: Department of Infectious Diseases, Leiden University Medical Centre, Leiden, The Netherlands 2: Department of Medical Microbiology and Immunology, Diakonessenhuis, Utrecht/Zeist, The Netherlands 3: Department of Tuberculosis Control, Municipal Health Authority, Utrecht, The Netherlands 4: Department of Pulmonology and Tuberculosis, Diakonessenhuis, Utrecht, The Netherlands

Publication date: November 1, 2008

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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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