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Free Content Diagnosis of latent tuberculosis infection in bacille Calmette-Guérin vaccinated subjects in China by interferon-gamma ELISpot assay

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Abstract:

OBJECTIVE: To evaluate the performance of an in-house interferon-gamma (IFN-γ) enzyme-linked immunospot (ELISpot) assay for the detection of latent tuberculosis infection (LTBI) in bacille Calmette-Guérin (BCG) vaccinated individuals with or without human immunodeficiency virus (HIV) infection.

METHODS: A total of 202 participants (93 HIV-infected and 109 non-infected) who received BCG vaccination at birth underwent tuberculin skin testing (TST) and T cell-based ELISpot assays. The performance of an in-house IFN-γ ELISpot assay (ELISpot) was evaluated by parallel comparison with the commercial IFN-γ release assay (IGRA) kit, T-SPOT®.TB, in 127 subjects. The effect of BCG vaccination on the ELISpot assay was prospectively determined by comparing the responses of IGRAs before and 3 months after BCG vaccination in 27 individuals.

RESULTS: High agreement between ELISpot and T-SPOT.TB was observed in both HIV-infected (92.47%, κ = 0.754) and non-HIV-infected subjects (97.06%, κ = 0.653). CD4+ T-cell count does not affect Mycobacterium tuberculosis IFN-γ response as measured by both ELISpot and T-SPOT.TB. BCG vaccination resulted in 100% conversion of TST, but did not change responses to IGRAs.

CONCLUSION: The performance of this in-house ELISpot assay is comparable to commercial T-SPOT.TB in diagnosing LTBI. Both assays are useful for diagnosing LTBI in BCG-vaccinated subjects with or without HIV infection in a setting with a high prevalence of tuberculosis.

Keywords: BCG vaccination; interferon-gamma release assays; latent tuberculosis infection

Document Type: Regular Paper

Affiliations: 1: Shenzhen Clinical Centre for Infectious Diseases, Shenzhen Third People's Hospital, Shenzhen, China 2: Department of Immunology, Affiliated Shenzhen Third Hospital, Guangdong Medical College, Shenzhen, China 3: Shenzhen Polytechnic College, Shenzhen, China 4: Department of Neurosurgery, University of Colorado Denver, Aurora, Colorado, USA 5: Shenzhen Clinical Centre for Infectious Diseases, Shenzhen Third People's Hospital, Shenzhen, China; and Department of Immunology, Affiliated Shenzhen Third Hospital, Guangdong Medical College, Shenzhen, China

Publication date: 2010-12-01

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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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