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Published online before print May 30, 2007
Eur Respir J 2007, doi:10.1183/09031936.00028507
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ORIGINAL ARTICLE

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

J-P. Janssens 1*, P. Roux-Lombard 2, T. Perneger 3, M. Metzger 1, R. Vivien 2, T. Rochat 1

1 Division of Pulmonary Diseases, Geneva University Hospital
2 Division of Immunology and Allergy, Geneva University Hospital
3 Quality of care division, Geneva University Hospital

* To whom correspondence should be addressed. E-mail: Jean-Paul.Janssens{at}hcuge.ch.


  Abstract

To assess the contribution of a {gamma}-Interferon release assay (T-SPOT.TB, Oxford Immunotec, UK) for differentiating active tuberculosis (TB) versus latent infection (LTBI) by quantifying spot forming units (SFU).

Prospective study of contacts exposed to a case of contagious TB and cases of HIV-negative culture-proven TB referred to our centre over a 16 month period.

Tuberculin skin tests (TST) and T-SPOT.TB were performed in contacts (n=310) 8-12 weeks after exposure. In subjects with culture proven TB, T-SPOT.TB was performed within 2 weeks of initiation of treatment. Analysis included all contacts with a positive T-SPOT.TB and all subjects with TB.

127 contacts and 58 cases of TB were included. Mean SFU values (±SD) were: 107±56 (range: 1-207) for TB, 54±60 (7-239; vs. TB: p<.0001) for contacts with positive T-SPOT.TB and TST>5 mm, and 19±27 (7-143; vs. TB: p<.0001) for contacts with positive T-SPOT.TB and TST≤5 mm. By ROC curve analysis, a threshold value of 49.5 SFU had a sensitivity of 83% and a specificity of 74% for distinguishing LTBI from TB.

Although SFU levels were significantly related to disease activity, the test cannot be recommended for diagnosing TB.

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




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