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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

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dc.contributor.authorKang, Young Ae-
dc.contributor.authorLee, Hye Won-
dc.contributor.authorYoon, Ho Il-
dc.contributor.authorCho, BeLong-
dc.contributor.authorHan, Sung Koo-
dc.contributor.authorShim, Young-Soo-
dc.contributor.authorYim, Jae-Joon-
dc.date.accessioned2009-11-09T06:50:03Z-
dc.date.available2009-11-09T06:50:03Z-
dc.date.issued2005-06-09-
dc.identifier.citationJAMA. 2005 Jun 8;293(22):2756-61.en
dc.identifier.issn1538-3598 (Electronic)-
dc.identifier.urihttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=15941805-
dc.identifier.urihttps://hdl.handle.net/10371/11598-
dc.description.abstractCONTEXT: 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.isoenen
dc.publisherAmerican Medical Associationen
dc.subjectAdolescenten
dc.subjectAdulten
dc.subjectAgeden
dc.subjectAntigens, Bacterial/immunologyen
dc.subjectBCG Vaccineen
dc.subjectBacterial Proteins/immunologyen
dc.subjectFemaleen
dc.subjectHumansen
dc.subjectInterferon-gamma/*immunologyen
dc.subjectKoreaen
dc.subjectMaleen
dc.subjectMiddle Ageden
dc.subjectMycobacterium tuberculosis/immunology/*isolation & purification/physiologyen
dc.subjectRisken
dc.subject*Tuberculin Testen
dc.subjectTuberculosis, Pulmonary/*diagnosis/immunologyen
dc.subjectVirus Latencyen
dc.titleDiscrepancy between the tuberculin skin test and the whole-blood interferon gamma assay for the diagnosis of latent tuberculosis infection in an intermediate tuberculosis-burden countryen
dc.typeArticleen
dc.contributor.AlternativeAuthor강영애-
dc.contributor.AlternativeAuthor이혜원-
dc.contributor.AlternativeAuthor윤호일-
dc.contributor.AlternativeAuthor조비룡-
dc.contributor.AlternativeAuthor한성구-
dc.contributor.AlternativeAuthor심영수-
dc.contributor.AlternativeAuthor임재준-
dc.identifier.doi10.1001/jama.293.22.2756-
Appears in Collections:
College of Medicine/School of Medicine (의과대학/대학원)Family Medicine (가정의학전공)Journal Papers (저널논문_가정의학전공)
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