Reduced sensitivity of the QuantiFERON (R) test in diabetic patients with smear-negative tuberculosis
- Authors
- Choi, J. C.; Jarlsberg, L. G.; Grinsdale, J. A.; Osmond, D. H.; Higashi, J.; Hopewell, P. C.; Kato-Maeda, M.
- Issue Date
- May-2015
- Publisher
- INT UNION AGAINST TUBERCULOSIS LUNG DISEASE (I U A T L D)
- Keywords
- Mycobacterium tuberculosis; latent tuberculous infection; tuberculin skin test
- Citation
- INTERNATIONAL JOURNAL OF TUBERCULOSIS AND LUNG DISEASE, v.19, no.5, pp 582 - 588
- Pages
- 7
- Journal Title
- INTERNATIONAL JOURNAL OF TUBERCULOSIS AND LUNG DISEASE
- Volume
- 19
- Number
- 5
- Start Page
- 582
- End Page
- 588
- URI
- https://scholarworks.bwise.kr/cau/handle/2019.sw.cau/9599
- DOI
- 10.5588/ijtld.14.0553
- ISSN
- 1027-3719
1815-7920
- Abstract
- SETTING: Immunosuppressive conditions have been associated with low sensitivity of interferon-gamma release assays (IGRAs) and the tuberculin skin test (TST) for the diagnosis of tuberculosis (TB). However, no systematic analysis of patient and bacterial characteristics has been performed before. OBJECTIVE: To determine the sensitivity and the risk factors for false-negative QuantiFERON (R)-TB (QFT) assay and TST in TB patients. DESIGN: We performed a retrospective analysis of data collected in a community-based study of TB in San Francisco, CA, USA. We included 300 TB patients who underwent QFT and TST. RESULTS: The risk factors for false-negative QFT were human immunodeficiency virus infection and the use of QuantiFERON (R)-TB Gold. In patients with sputum smear-negative TB, diabetes mellitus (DM) was associated with false-negative QFT (OR 2.85, 95%CI 1.02-7.97, P = 0.045). TST sensitivity was higher than QFT sensitivity in DM patients (OR 9.46, 95%CI 2.53-35.3). CONCLUSIONS: In San Francisco, QFT sensitivity was lower than that of TST, especially in patients with DM. Stratified analysis by sputum smear results showed that this association was specific to smear-negative TB. In contrast, TST was not affected by the presence of DM.
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