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A retrospective study of the indications for the use of interferon gamma release assays (IGRA) in a United Kingdom (UK) district general hospital (DGH) tuberculosis (TB) clinic

Jennifer Kerks, Callum Gandolfi, Harmesh Moudgil, Thirumalai Naicker, Nawaid Ahmad, Sue George, Koottalai Srinivasan
European Respiratory Journal 2015 46: PA2968; DOI: 10.1183/13993003.congress-2015.PA2968
Jennifer Kerks
Respiratory Medicine, Princess Royal Hospital, Telford, Shropshire United Kingdom
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Callum Gandolfi
Respiratory Medicine, Princess Royal Hospital, Telford, Shropshire United Kingdom
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Harmesh Moudgil
Respiratory Medicine, Princess Royal Hospital, Telford, Shropshire United Kingdom
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Thirumalai Naicker
Respiratory Medicine, Princess Royal Hospital, Telford, Shropshire United Kingdom
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Nawaid Ahmad
Respiratory Medicine, Princess Royal Hospital, Telford, Shropshire United Kingdom
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Sue George
Respiratory Medicine, Princess Royal Hospital, Telford, Shropshire United Kingdom
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Koottalai Srinivasan
Respiratory Medicine, Princess Royal Hospital, Telford, Shropshire United Kingdom
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Abstract

Background: Interferon gamma release assay (IGRA) is a relatively new investigation for the diagnosis of latent TB. After initial interest in this test for diagnosis of active TB, NICE recommends the use of IGRA in the diagnosis of latent TB only, as set out by guidance in 2010.

Aim: This study was to audit the number of tests done since the introduction of IGRAs to the DGH in 2011 and whether they were being used in accordance with NICE guidance.

Method: Retrospective review of the electronic hospital records for patients who had IGRA tested between April 2011 and December 2011. The reason for the test was categorised into: diagnosing active TB, contact tracing, pre biological therapy, new entrant screening or other. The result of the test; tuberculin skin test (TST) prior to IGRA and result; and any treatment given for TB was recorded.

Results: 260 tests were done, 13 were excluded.

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Table showing the number of IGRAs done for each category with results of IGRA and prior TST if done

Conclusion: Our study found that IGRAs were being used for diagnosing active TB in spite of national guidelines not recommending it. The indication for the additional use of TST in those having IGRA was inconsistent. Algorithmic guidelines for the use of IGRA, as well as TST prior to IGRA need to be adopted in local hospitals to ensure proper use of resources.

  • Tuberculosis - diagnosis
  • IGRA (Interferon gamma)
  • Immunosuppression
  • Copyright ©ERS 2015
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A retrospective study of the indications for the use of interferon gamma release assays (IGRA) in a United Kingdom (UK) district general hospital (DGH) tuberculosis (TB) clinic
Jennifer Kerks, Callum Gandolfi, Harmesh Moudgil, Thirumalai Naicker, Nawaid Ahmad, Sue George, Koottalai Srinivasan
European Respiratory Journal Sep 2015, 46 (suppl 59) PA2968; DOI: 10.1183/13993003.congress-2015.PA2968

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A retrospective study of the indications for the use of interferon gamma release assays (IGRA) in a United Kingdom (UK) district general hospital (DGH) tuberculosis (TB) clinic
Jennifer Kerks, Callum Gandolfi, Harmesh Moudgil, Thirumalai Naicker, Nawaid Ahmad, Sue George, Koottalai Srinivasan
European Respiratory Journal Sep 2015, 46 (suppl 59) PA2968; DOI: 10.1183/13993003.congress-2015.PA2968
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