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Published online before print May 30, 2007, 10.1183/09031936.00028507
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Eur Respir J 2007; 30:722-728
Copyright ©ERS Journals Ltd 2007

Quantitative scoring of an interferon-{gamma} assay for differentiating active from latent tuberculosis

J-P. Janssens1, P. Roux-Lombard2, T. Perneger3, M. Metzger1, R. Vivien2 and T. Rochat1

Divisions of 1 Pulmonary Diseases, 2 Immunology and Allergy, and 3 Quality of Care, Geneva University Hospital, Geneva, Switzerland.

CORRESPONDENCE: J-P. Janssens, Centre antituberculeux, Hôpital Cantonal Universitaire, 1211 Geneva 14, Switzerland. Fax: 41 223729929. E-mail: Jean-Paul.Janssens{at}hcuge.ch

Keywords: Interferon-{gamma} release assays, latent tuberculosis infection, tuberculosis

Received: March 11, 2007
Accepted May 14, 2007

The aim of this study was to assess the contribution of an interferon-{gamma} release assay (T-SPOT.TB) to the differentiation of active tuberculosis (TB) from latent TB infection by quantifying spot-forming units (sfu).

The investigation was a prospective study of contacts exposed to a case of contagious TB and cases of HIV-negative culture-proven TB referred over a 16-month period. Tuberculin skin tests (TSTs) and T-SPOT.TB were performed in 310 contacts 8–12 weeks after exposure. In subjects with culture-proven TB, T-SPOT.TB was performed within 2 weeks of initiation of treatment. The analysis included all contacts with a positive T-SPOT.TB result and all subjects with TB.

TB contacts (n = 127) and cases (n = 58) were included. Mean±SD T-SPOT.TB results were 107±56 (range 1–207) sfu for TB, 54±60 (7–239) sfu for contacts with positive T-SPOT.TB results and a TST induration diameter of >5 mm, and 19±27 (7–143) sfu for contacts with positive T-SPOT.TB results and a TST induration diameter of ≤5 mm. By receiver operating characteristic curve analysis, a threshold value of 49.5 sfu showed a sensitivity of 83% and specificity of 74% for distinguishing latent TB infection from TB.

Although T-SPOT.TB results were significantly related to disease activity, the test cannot be recommended for the diagnosis of tuberculosis.




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