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Home / The International Journal of Tuberculosis and Lung Disease, Volume 15, Number 8

Predictors of discordant tuberculin skin test and QuantiFERON®-TB Gold In-Tube results in various high-risk groups

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SETTING: Persons in whom targeted testing for latent tuberculosis infection (LTBI) is recommended in Seattle, Washington; Atlanta, Georgia; and central North Carolina, United States.

OBJECTIVE: To compare the performance of an interferon-gamma release assay (QuantiFERON®-TB Gold In-Tube [QFT-GIT]) with the tuberculin skin test (TST) among foreign-born, homeless, human immunodeficiency virus (HIV) infected and substance abuse persons tested for LTBI.

DESIGN: A cross-sectional study requiring participants to have a blood test, a TST and data collected.

RESULTS: Of 1653 persons, 19.5% were TST-positive and 14.0% were QFT-GIT-positive. Overall concordance was moderate (kappa 0.53; 95%CI 0.47–0.58). Compared to concordant positive results, TST+/QFT-GIT− discordance was associated with HIV infection and sex, while TST−/QFT-GIT+ discordance was associated with HIV and inversely associated with foreign birth. Compared to concordant negative results, TST−/QFT-GIT+ discordance was associated with foreign birth and age ≥50 years, while TST+/QFT-GIT-discordance was associated with foreign birth, age 30–49 years, being Black and inversely associated with HIV. HIV infection was significantly associated with indeterminate QFT-GIT results.

CONCLUSION: QFT-GIT may be an improvement over the TST for diagnosing LTBI in foreign-born and older persons, and may be as useful as the TST in HIV-infected persons. The sensitivity of both tests may be low in HIV-infected persons.

Keywords: QuantiFERON-TB Gold In-Tube; discordance; latent tuberculosis infection; tuberculin skin test

Document Type: Regular Paper

Affiliations: 1: Westat, Rockville, Maryland, USA 2: Division of Infectious Diseases, Department of Medicine, Emory University School of Medicine, Atlanta, Georgia, USA 3: Snohomish Health District, Everett, Washington, USA 4: RTI International, Research Triangle Park, North Carolina, USA 5: Seattle-King County Department of Public Health, Seattle, Washington, USA 6: Centers for Disease Control and Prevention, Atlanta, Georgia, USA

Publication date: 01 August 2011

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  • The International Journal of Tuberculosis and Lung Disease (IJTLD) is for clinical research and epidemiological studies on lung health, including articles on TB, TB-HIV and respiratory diseases such as COVID-19, asthma, COPD, child lung health and the hazards of tobacco and air pollution. Individuals and institutes can subscribe to the IJTLD online or in print – simply email us at [email protected] for details.

    The IJTLD is dedicated to understanding lung disease and to the dissemination of knowledge leading to better lung health. To allow us to share scientific research as rapidly as possible, the IJTLD is fast-tracking the publication of certain articles as preprints prior to their publication. Read fast-track articles.

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