Comparison of a whole-blood interferon γ assay with tuberculin skin testing for detecting latent Mycobacterium tuberculosis infection

Gerald H. Mazurek, Philip A. Lobue, Charles L. Daley, John Bernardo, Alfred A. Lardizabal, William Ramses Bishai, Michael F. Iademarco, James S. Rothel

Research output: Contribution to journalArticle

Abstract

Context: Identifying persons with latent tuberculosis infection (LTBI) is crucial to the goal of TB elimination. A whole-blood interferon γ (IFN-γ) assay, the Quanti-FERON-TB test, is a promising in vitro diagnostic test for LTBI that has potential advantages over the tuberculin skin test (TST). Objectives: To compare the IFN-γ assay with the TST and to identify factors associated with discordance between the tests. Design and Setting: Prospective comparison study conducted at 5 university-affiliated sites in the United States between March 1, 1998 and June 30, 1999. Participants: A total of 1226 adults (mean age, 39 years) with varying risks of Mycobacterium tuberculosis infection or documented or suspected active TB, all of whom underwent both the IFN-γ assay and the TST. Main Outcome Measure: Level of agreement between the IFN-γ assay and the TST. Results: Three hundred ninety participants (31.8%) had a positive TST result and 349 (28.5%) had a positive IFN-γ assay result. Overall agreement between the IFN-γ assay and the TST was 83.1% (K=0.60). Multivariate analysis revealed that the odds of having a positive TST result but negative IFN-γ assay result were 7 times higher for BCG-vaccinated persons compared with unvaccinated persons. The IFN-γ assay provided evidence that among unvaccinated persons with a positive TST result but negative IFN-γ assay result, 21.2% were responding to mycobacteria other than M tuberculosis. Conclusions: For all study participants, as well as for those being screened for LTBI, the IFN-γ assay was comparable with the TST in its ability to detect LTBI, was less affected by BCG vaccination, discriminated responses due to nontuberculous mycobacteria, and avoided variability and subjectivity associated with placing and reading the TST.

Original languageEnglish (US)
Pages (from-to)1740-1747
Number of pages8
JournalJournal of the American Medical Association
Volume286
Issue number14
StatePublished - Oct 10 2001

Fingerprint

Latent Tuberculosis
Tuberculin Test
Mycobacterium Infections
Tuberculin
Skin Tests
Mycobacterium tuberculosis
Interferons
Skin
Mycobacterium bovis
Nontuberculous Mycobacteria
Mycobacterium
Routine Diagnostic Tests
Reading
Vaccination
Tuberculosis
Multivariate Analysis
Outcome Assessment (Health Care)
Prospective Studies

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Comparison of a whole-blood interferon γ assay with tuberculin skin testing for detecting latent Mycobacterium tuberculosis infection. / Mazurek, Gerald H.; Lobue, Philip A.; Daley, Charles L.; Bernardo, John; Lardizabal, Alfred A.; Bishai, William Ramses; Iademarco, Michael F.; Rothel, James S.

In: Journal of the American Medical Association, Vol. 286, No. 14, 10.10.2001, p. 1740-1747.

Research output: Contribution to journalArticle

Mazurek, GH, Lobue, PA, Daley, CL, Bernardo, J, Lardizabal, AA, Bishai, WR, Iademarco, MF & Rothel, JS 2001, 'Comparison of a whole-blood interferon γ assay with tuberculin skin testing for detecting latent Mycobacterium tuberculosis infection', Journal of the American Medical Association, vol. 286, no. 14, pp. 1740-1747.
Mazurek, Gerald H. ; Lobue, Philip A. ; Daley, Charles L. ; Bernardo, John ; Lardizabal, Alfred A. ; Bishai, William Ramses ; Iademarco, Michael F. ; Rothel, James S. / Comparison of a whole-blood interferon γ assay with tuberculin skin testing for detecting latent Mycobacterium tuberculosis infection. In: Journal of the American Medical Association. 2001 ; Vol. 286, No. 14. pp. 1740-1747.
@article{4fa3461cb94841fb9e4a65dab9cc7db9,
title = "Comparison of a whole-blood interferon γ assay with tuberculin skin testing for detecting latent Mycobacterium tuberculosis infection",
abstract = "Context: Identifying persons with latent tuberculosis infection (LTBI) is crucial to the goal of TB elimination. A whole-blood interferon γ (IFN-γ) assay, the Quanti-FERON-TB test, is a promising in vitro diagnostic test for LTBI that has potential advantages over the tuberculin skin test (TST). Objectives: To compare the IFN-γ assay with the TST and to identify factors associated with discordance between the tests. Design and Setting: Prospective comparison study conducted at 5 university-affiliated sites in the United States between March 1, 1998 and June 30, 1999. Participants: A total of 1226 adults (mean age, 39 years) with varying risks of Mycobacterium tuberculosis infection or documented or suspected active TB, all of whom underwent both the IFN-γ assay and the TST. Main Outcome Measure: Level of agreement between the IFN-γ assay and the TST. Results: Three hundred ninety participants (31.8{\%}) had a positive TST result and 349 (28.5{\%}) had a positive IFN-γ assay result. Overall agreement between the IFN-γ assay and the TST was 83.1{\%} (K=0.60). Multivariate analysis revealed that the odds of having a positive TST result but negative IFN-γ assay result were 7 times higher for BCG-vaccinated persons compared with unvaccinated persons. The IFN-γ assay provided evidence that among unvaccinated persons with a positive TST result but negative IFN-γ assay result, 21.2{\%} were responding to mycobacteria other than M tuberculosis. Conclusions: For all study participants, as well as for those being screened for LTBI, the IFN-γ assay was comparable with the TST in its ability to detect LTBI, was less affected by BCG vaccination, discriminated responses due to nontuberculous mycobacteria, and avoided variability and subjectivity associated with placing and reading the TST.",
author = "Mazurek, {Gerald H.} and Lobue, {Philip A.} and Daley, {Charles L.} and John Bernardo and Lardizabal, {Alfred A.} and Bishai, {William Ramses} and Iademarco, {Michael F.} and Rothel, {James S.}",
year = "2001",
month = "10",
day = "10",
language = "English (US)",
volume = "286",
pages = "1740--1747",
journal = "JAMA - Journal of the American Medical Association",
issn = "0098-7484",
publisher = "American Medical Association",
number = "14",

}

TY - JOUR

T1 - Comparison of a whole-blood interferon γ assay with tuberculin skin testing for detecting latent Mycobacterium tuberculosis infection

AU - Mazurek, Gerald H.

AU - Lobue, Philip A.

AU - Daley, Charles L.

AU - Bernardo, John

AU - Lardizabal, Alfred A.

AU - Bishai, William Ramses

AU - Iademarco, Michael F.

AU - Rothel, James S.

PY - 2001/10/10

Y1 - 2001/10/10

N2 - Context: Identifying persons with latent tuberculosis infection (LTBI) is crucial to the goal of TB elimination. A whole-blood interferon γ (IFN-γ) assay, the Quanti-FERON-TB test, is a promising in vitro diagnostic test for LTBI that has potential advantages over the tuberculin skin test (TST). Objectives: To compare the IFN-γ assay with the TST and to identify factors associated with discordance between the tests. Design and Setting: Prospective comparison study conducted at 5 university-affiliated sites in the United States between March 1, 1998 and June 30, 1999. Participants: A total of 1226 adults (mean age, 39 years) with varying risks of Mycobacterium tuberculosis infection or documented or suspected active TB, all of whom underwent both the IFN-γ assay and the TST. Main Outcome Measure: Level of agreement between the IFN-γ assay and the TST. Results: Three hundred ninety participants (31.8%) had a positive TST result and 349 (28.5%) had a positive IFN-γ assay result. Overall agreement between the IFN-γ assay and the TST was 83.1% (K=0.60). Multivariate analysis revealed that the odds of having a positive TST result but negative IFN-γ assay result were 7 times higher for BCG-vaccinated persons compared with unvaccinated persons. The IFN-γ assay provided evidence that among unvaccinated persons with a positive TST result but negative IFN-γ assay result, 21.2% were responding to mycobacteria other than M tuberculosis. Conclusions: For all study participants, as well as for those being screened for LTBI, the IFN-γ assay was comparable with the TST in its ability to detect LTBI, was less affected by BCG vaccination, discriminated responses due to nontuberculous mycobacteria, and avoided variability and subjectivity associated with placing and reading the TST.

AB - Context: Identifying persons with latent tuberculosis infection (LTBI) is crucial to the goal of TB elimination. A whole-blood interferon γ (IFN-γ) assay, the Quanti-FERON-TB test, is a promising in vitro diagnostic test for LTBI that has potential advantages over the tuberculin skin test (TST). Objectives: To compare the IFN-γ assay with the TST and to identify factors associated with discordance between the tests. Design and Setting: Prospective comparison study conducted at 5 university-affiliated sites in the United States between March 1, 1998 and June 30, 1999. Participants: A total of 1226 adults (mean age, 39 years) with varying risks of Mycobacterium tuberculosis infection or documented or suspected active TB, all of whom underwent both the IFN-γ assay and the TST. Main Outcome Measure: Level of agreement between the IFN-γ assay and the TST. Results: Three hundred ninety participants (31.8%) had a positive TST result and 349 (28.5%) had a positive IFN-γ assay result. Overall agreement between the IFN-γ assay and the TST was 83.1% (K=0.60). Multivariate analysis revealed that the odds of having a positive TST result but negative IFN-γ assay result were 7 times higher for BCG-vaccinated persons compared with unvaccinated persons. The IFN-γ assay provided evidence that among unvaccinated persons with a positive TST result but negative IFN-γ assay result, 21.2% were responding to mycobacteria other than M tuberculosis. Conclusions: For all study participants, as well as for those being screened for LTBI, the IFN-γ assay was comparable with the TST in its ability to detect LTBI, was less affected by BCG vaccination, discriminated responses due to nontuberculous mycobacteria, and avoided variability and subjectivity associated with placing and reading the TST.

UR - http://www.scopus.com/inward/record.url?scp=0035840882&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0035840882&partnerID=8YFLogxK

M3 - Article

C2 - 11594899

AN - SCOPUS:0035840882

VL - 286

SP - 1740

EP - 1747

JO - JAMA - Journal of the American Medical Association

JF - JAMA - Journal of the American Medical Association

SN - 0098-7484

IS - 14

ER -