Format

Send to

Choose Destination
Int Arch Occup Environ Health. 2011 Apr;84(4):461-9. doi: 10.1007/s00420-010-0571-x. Epub 2010 Aug 19.

Serial testing with the interferon-γ release assay in Portuguese healthcare workers.

Author information

1
Occupational Health Division, Hospital S. João, Alameda Professor Hernâni Monteiro, Porto, Portugal.

Abstract

OBJECTIVES:

Evidence for the utility of the new Mycobacterium tuberculosis (MTB) specific IFN-γ release assays in diagnosing latent tuberculosis infection (LTBI) is growing. However, data concerning conversion and reversion rates in serial testing of healthcare workers (HCWs) with an interferon-γ release assay are sparse.

METHODS:

Between February 2007 and September 2009, 670 HCWs in the University Hospital of Porto, Portugal were tested at least twice with QuantiFERON-TB® Gold In-Tube (QFT) for LTBI. The tuberculin skin test (TST) was performed simultaneously. QFT was considered positive if INF-γ ≥0.35 IU/mL. TST conversion was defined as an increase ≥10 or ≥6 mm compared to a baseline TST <10 mm.

RESULTS:

The second QFT was positive in 4.8% of the 376 HCWs with an INF-γ concentration at baseline below 0.1 IU/mL but in 48.8% of the 41 HCWs with an INF-γ concentration of 0.2 to <0.35 IU/mL. Out of 74 HCWs with a baseline INF-γ concentration ≥3.0 IU/mL, 4 (5.4%) reversed while 27 out of 55 HCWs (49%) with a baseline INF-γ concentration ≥0.35 to <0.7 IU/mL reversed to a negative QFT. Those 61 HCWs with TST conversion (increase ≥10 mm) were most often (78.7%) negative in both consecutive QFTs.

CONCLUSION:

Our data suggests the use of an uncertainty zone between 0.2 and 0.7 IU/mL in serial testing with QFT. As long as the knowledge regarding disease progression in QFT-positive persons is limited, persons pertaining to this zone should be retested before being offered preventive chemotherapy.

PMID:
20721576
PMCID:
PMC3058548
DOI:
10.1007/s00420-010-0571-x
[Indexed for MEDLINE]
Free PMC Article

Supplemental Content

Full text links

Icon for Springer Icon for PubMed Central
Loading ...
Support Center