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Discrepancy between the tuberculin skin test and the whole-blood interferon gamma assay for the diagnosis of latent tuberculosis infection in an intermediate tuberculosis-burden country
DC Field | Value | Language |
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dc.contributor.author | Kang, Young Ae | - |
dc.contributor.author | Lee, Hye Won | - |
dc.contributor.author | Yoon, Ho Il | - |
dc.contributor.author | Cho, BeLong | - |
dc.contributor.author | Han, Sung Koo | - |
dc.contributor.author | Shim, Young-Soo | - |
dc.contributor.author | Yim, Jae-Joon | - |
dc.date.accessioned | 2009-11-09T06:50:03Z | - |
dc.date.available | 2009-11-09T06:50:03Z | - |
dc.date.issued | 2005-06-09 | - |
dc.identifier.citation | JAMA. 2005 Jun 8;293(22):2756-61. | en |
dc.identifier.issn | 1538-3598 (Electronic) | - |
dc.identifier.uri | http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=15941805 | - |
dc.identifier.uri | https://hdl.handle.net/10371/11598 | - |
dc.description.abstract | CONTEXT: A recently developed whole-blood interferon gamma (IFN-gamma) assay based on stimulation with the Mycobacterium tuberculosis-specific antigens early secreted antigenic target 6 and culture filtrate protein 10 shows promise for the diagnosis of latent tuberculosis (TB) infection. OBJECTIVE: To compare the tuberculin skin test (TST) and the whole-blood IFN-gamma assay in the diagnosis of latent TB infection according to the intensity of exposure. DESIGN AND SETTING: A prospective comparison between the whole-blood IFN-gamma assay and the TST using a 2-TU dose of purified protein derivative RT23 in a population with intermediate TB burden was conducted sequentially between February 1, 2004, and February 28, 2005, in a Korean tertiary referral hospital. PARTICIPANTS: Of 273 participants, 220 (95.7%) had received BCG vaccine. Participants were grouped according to their risk of infection: group 1, no identifiable risk of M tuberculosis infection (n = 99); group 2, recent casual contacts (n = 72); group 3, recent close contacts (n = 48); group 4, bacteriologically or pathologically confirmed TB patients (n = 54). MAIN OUTCOME MEASURES: Levels of agreement between the TST and the IFN-gamma assay and the likelihood of infection in the various groups. RESULTS: For the TST with a 10-mm induration cutoff, the positive response rate in group 1 was 51%; group 2, 60%; group 3, 71%, and group 4, 78%. For the IFN-gamma assay, the positive response rate in group 1 was 4%; group 2, 10%; group 3, 44%; and group 4, 81%. The overall agreement between the TST and the IFN-gamma assay in healthy volunteers was kappa = 0.16. The odds of a positive test result per unit increase in exposure across the 4 groups increased by a factor of 5.31 (95% confidence interval [CI], 3.62-7.79) for the IFN-gamma assay and by a factor of 1.52 (95% CI, 1.20-1.91) for the TST (P<.001). Using a 15-mm induration cutoff for the TST did not make a substantial difference to the test results. CONCLUSION: The IFN-gamma assay is a better indicator of the risk of M tuberculosis infection than TST in a BCG-vaccinated population. | en |
dc.language.iso | en | en |
dc.publisher | American Medical Association | en |
dc.subject | Adolescent | en |
dc.subject | Adult | en |
dc.subject | Aged | en |
dc.subject | Antigens, Bacterial/immunology | en |
dc.subject | BCG Vaccine | en |
dc.subject | Bacterial Proteins/immunology | en |
dc.subject | Female | en |
dc.subject | Humans | en |
dc.subject | Interferon-gamma/*immunology | en |
dc.subject | Korea | en |
dc.subject | Male | en |
dc.subject | Middle Aged | en |
dc.subject | Mycobacterium tuberculosis/immunology/*isolation & purification/physiology | en |
dc.subject | Risk | en |
dc.subject | Tuberculosis, Pulmonary/*diagnosis/immunology | en |
dc.subject | Virus Latency | en |
dc.subject | Tuberculin Test | - |
dc.title | Discrepancy between the tuberculin skin test and the whole-blood interferon gamma assay for the diagnosis of latent tuberculosis infection in an intermediate tuberculosis-burden country | en |
dc.type | Article | en |
dc.contributor.AlternativeAuthor | 강영애 | - |
dc.contributor.AlternativeAuthor | 이혜원 | - |
dc.contributor.AlternativeAuthor | 윤호일 | - |
dc.contributor.AlternativeAuthor | 조비룡 | - |
dc.contributor.AlternativeAuthor | 한성구 | - |
dc.contributor.AlternativeAuthor | 심영수 | - |
dc.contributor.AlternativeAuthor | 임재준 | - |
dc.identifier.doi | 10.1001/jama.293.22.2756 | - |
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