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Factors that Predict Negative Results of QuantiFERON-TB Gold In-Tube Test in Patients with Culture-Confirmed Tuberculosis: A Multicenter Retrospective Cohort Study

BACKGROUND: Interferon-γ release assays such as the QuantiFERON-TB Gold In-Tube Test (QFT-GIT) are designed to detect Mycobacterium tuberculosis infections, whether latent or manifesting as disease. However, a substantial number of persons with culture-confirmed tuberculosis (TB) have negative QFT-G...

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Autores principales: Kwon, Yong-Soo, Kim, Yee Hyung, Jeon, Kyeongman, Jeong, Byeong-Ho, Ryu, Yon Ju, Choi, Jae Chol, Kim, Ho Cheol, Koh, Won-Jung
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4466377/
https://www.ncbi.nlm.nih.gov/pubmed/26070207
http://dx.doi.org/10.1371/journal.pone.0129792
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author Kwon, Yong-Soo
Kim, Yee Hyung
Jeon, Kyeongman
Jeong, Byeong-Ho
Ryu, Yon Ju
Choi, Jae Chol
Kim, Ho Cheol
Koh, Won-Jung
author_facet Kwon, Yong-Soo
Kim, Yee Hyung
Jeon, Kyeongman
Jeong, Byeong-Ho
Ryu, Yon Ju
Choi, Jae Chol
Kim, Ho Cheol
Koh, Won-Jung
author_sort Kwon, Yong-Soo
collection PubMed
description BACKGROUND: Interferon-γ release assays such as the QuantiFERON-TB Gold In-Tube Test (QFT-GIT) are designed to detect Mycobacterium tuberculosis infections, whether latent or manifesting as disease. However, a substantial number of persons with culture-confirmed tuberculosis (TB) have negative QFT-GITs. Information on host factors contributing to false-negative and indeterminate results are limited. METHODS: A multicenter retrospective cohort study was performed with 1,264 culture-confirmed TB patients older than 18 years who were subjected to the QFT-GIT at one of the six hospitals between May 2007 and February 2014. Patients with human immunodeficiency virus infection were excluded. Clinical and laboratory data were collected in South Korea. RESULTS: Of all patients, 87.6% (1,107/1,264) were diagnosed with pulmonary TB and 12.4% (157/1,264) with extrapulmonary TB. The rate of negative results was 14.4% (182/1,264). The following factors were highly correlated with false-negative results in the QFT-GIT: advanced age (age ≥ 65 years, odds ratio [OR] 1.57, 95% confidence interval [CI] 1.03–2.39), bilateral disease as determined by chest radiography (OR 1.75, 95% CI 1.13–2.72), malignancy (OR 2.42, 95% CI 1.30–4.49), and lymphocytopenia (total lymphocyte count < 1.0 × 10(9)/L, OR 1.86, 95% CI 1.21–2.87). CONCLUSIONS: Consequently, QFT-GIT results need to be interpreted with caution in patients with these host risk factors such as the elderly, bilateral disease on chest radiography, or malignancy, or lymphocytopenia.
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spelling pubmed-44663772015-06-22 Factors that Predict Negative Results of QuantiFERON-TB Gold In-Tube Test in Patients with Culture-Confirmed Tuberculosis: A Multicenter Retrospective Cohort Study Kwon, Yong-Soo Kim, Yee Hyung Jeon, Kyeongman Jeong, Byeong-Ho Ryu, Yon Ju Choi, Jae Chol Kim, Ho Cheol Koh, Won-Jung PLoS One Research Article BACKGROUND: Interferon-γ release assays such as the QuantiFERON-TB Gold In-Tube Test (QFT-GIT) are designed to detect Mycobacterium tuberculosis infections, whether latent or manifesting as disease. However, a substantial number of persons with culture-confirmed tuberculosis (TB) have negative QFT-GITs. Information on host factors contributing to false-negative and indeterminate results are limited. METHODS: A multicenter retrospective cohort study was performed with 1,264 culture-confirmed TB patients older than 18 years who were subjected to the QFT-GIT at one of the six hospitals between May 2007 and February 2014. Patients with human immunodeficiency virus infection were excluded. Clinical and laboratory data were collected in South Korea. RESULTS: Of all patients, 87.6% (1,107/1,264) were diagnosed with pulmonary TB and 12.4% (157/1,264) with extrapulmonary TB. The rate of negative results was 14.4% (182/1,264). The following factors were highly correlated with false-negative results in the QFT-GIT: advanced age (age ≥ 65 years, odds ratio [OR] 1.57, 95% confidence interval [CI] 1.03–2.39), bilateral disease as determined by chest radiography (OR 1.75, 95% CI 1.13–2.72), malignancy (OR 2.42, 95% CI 1.30–4.49), and lymphocytopenia (total lymphocyte count < 1.0 × 10(9)/L, OR 1.86, 95% CI 1.21–2.87). CONCLUSIONS: Consequently, QFT-GIT results need to be interpreted with caution in patients with these host risk factors such as the elderly, bilateral disease on chest radiography, or malignancy, or lymphocytopenia. Public Library of Science 2015-06-12 /pmc/articles/PMC4466377/ /pubmed/26070207 http://dx.doi.org/10.1371/journal.pone.0129792 Text en © 2015 Kwon et al http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are properly credited.
spellingShingle Research Article
Kwon, Yong-Soo
Kim, Yee Hyung
Jeon, Kyeongman
Jeong, Byeong-Ho
Ryu, Yon Ju
Choi, Jae Chol
Kim, Ho Cheol
Koh, Won-Jung
Factors that Predict Negative Results of QuantiFERON-TB Gold In-Tube Test in Patients with Culture-Confirmed Tuberculosis: A Multicenter Retrospective Cohort Study
title Factors that Predict Negative Results of QuantiFERON-TB Gold In-Tube Test in Patients with Culture-Confirmed Tuberculosis: A Multicenter Retrospective Cohort Study
title_full Factors that Predict Negative Results of QuantiFERON-TB Gold In-Tube Test in Patients with Culture-Confirmed Tuberculosis: A Multicenter Retrospective Cohort Study
title_fullStr Factors that Predict Negative Results of QuantiFERON-TB Gold In-Tube Test in Patients with Culture-Confirmed Tuberculosis: A Multicenter Retrospective Cohort Study
title_full_unstemmed Factors that Predict Negative Results of QuantiFERON-TB Gold In-Tube Test in Patients with Culture-Confirmed Tuberculosis: A Multicenter Retrospective Cohort Study
title_short Factors that Predict Negative Results of QuantiFERON-TB Gold In-Tube Test in Patients with Culture-Confirmed Tuberculosis: A Multicenter Retrospective Cohort Study
title_sort factors that predict negative results of quantiferon-tb gold in-tube test in patients with culture-confirmed tuberculosis: a multicenter retrospective cohort study
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4466377/
https://www.ncbi.nlm.nih.gov/pubmed/26070207
http://dx.doi.org/10.1371/journal.pone.0129792
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