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Comparison of QFT-Plus and QFT-GIT tests for diagnosis of M. tuberculosis infection in immunocompetent Korean subjects

Authors
 Ji Young Hong  ;  So Yeong Park  ;  Ahreum Kim  ;  Sang-Nae Cho  ;  Yun-Gyoung Hur 
Citation
 JOURNAL OF THORACIC DISEASE, Vol.11(12) : 5210-5217, 2019 
Journal Title
JOURNAL OF THORACIC DISEASE
ISSN
 2072-1439 
Issue Date
2019
Keywords
Diagnosis ; Mycobacterium tuberculosis (M. tb) ; QFT-Plus ; QuantiFERON-TB Gold In-Tube (QFT-GIT) ; latent tuberculosis infection (LTBI) ; tuberculosis (TB)
Abstract
Background:

QFT-Plus is a recently developed next-generation QuantiFERON-TB Gold In-Tube (QFT-GIT) test. Unlike the QFT-GIT test, it includes a TB2 antigen tube with peptides that may stimulate CD8+ T cells. This study evaluated the diagnostic performance of QFT-Plus and compared it with that of QFT-GIT.

Methods:

QFT-Plus and QFT-GIT tests were performed in 33 patients with active tuberculosis (TB) and 57 healthy controls including subjects with latent TB infection (LTBI). Positivity and negativity of IFN-γ responses were compared between tests, and total concordance of the outcome was analyzed.

Results:

Positive and negative outcomes of QFT-Plus and QFT-GIT tests showed substantial agreement (91.1%, kappa=0.8). The sensitivity and the specificity of QFT-Plus (93.9% sensitivity, 92.6% specificity) were similar with those of QFT-GIT (93.9% sensitivity, 100% specificity). Of eight discordant results, five (5.56%) and three (3.3%) were positive in QFT-GIT alone and QFT-plus alone, respectively. Reactivity in the TB2 tube contributes to the difference between QFT-GIT and QFT-Plus. Median IFN-γ production in TB2 (10.0 IU/mL in TB, 3.850 IU/mL in LTBI, P=0.001) is significantly higher in the TB group than the LTBI group. The QFT-Plus did not clearly discriminate between active TB and latent TB, although it showed significantly lower IFN-γ concentrations compared with the QFT-GIT in individuals with LTBI (3.850 vs. 7.205 IU/mL).

Conclusions:

Similar accuracy of detecting Mycobacterium tuberculosis infection was observed for QFT-Plus and QFT-GIT tests in immunocompetent patients and healthy controls, including those with LTBI. Improved efficacy for identifying M. tuberculosis infection was not found with the QFT-Plus, but further studies in a larger population may confirm the clinical significance of positive response in the TB2 tube of QFT-Plus.
Files in This Item:
T201906017.pdf Download
DOI
10.21037/jtd.2019.12.11
Appears in Collections:
1. College of Medicine (의과대학) > Research Institute (부설연구소) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Microbiology (미생물학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Yonsei Biomedical Research Center (연세의생명연구원) > 1. Journal Papers
Yonsei Authors
Kim, Ah Reum(김아름) ORCID logo https://orcid.org/0000-0001-5938-4270
Cho, Sang Nae(조상래)
Hur, Yun-Gyoung(허윤경) ORCID logo https://orcid.org/0000-0003-3986-4394
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/175469
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