Abstract
BackgroundThe role of interferon-γ release assay (IGRA) in monitoring responses to anti-tuberculosis (TB) treatment is not clear. We evaluated the results of the QuantiFERON-TB Gold In-tube (QFT-GIT) assay over time during the anti-TB treatment of adults with no underlying disease.MethodsWe enrolled soldiers who were newly diagnosed with active TB and admitted to the central referral military hospital in South Korea between May 1, 2008 and September 30, 2009. For each participant, we preformed QFT-GIT assay before treatment (baseline) and at 1, 3, and 6 months after initiating anti-TB medication.ResultsOf 67 eligible patients, 59 (88.1%) completed the study protocol. All participants were males who were human immunodeficiency virus (HIV)-negative and had no chronic diseases. Their median age was 21 years (range, 20-48). Initially, 57 (96.6%) patients had positive QFT-GIT results, and 53 (89.8%), 42 (71.2%), and 39 (66.1%) had positive QFT-GIT results at 1, 3, and 6 months, respectively. The IFN-γ level at baseline was 5.31 ± 5.34 IU/ml, and the levels at 1, 3, and 6 months were 3.95 ± 4.30, 1.82 ± 2.14, and 1.50 ± 2.12 IU/ml, respectively. All patients had clinical and radiologic improvements after treatment and were cured. A lower IFN-γ level, C-reactive protein ≥ 3 mg/dl, and the presence of fever (≥ 38.3°C) at diagnosis were associated with negative reversion of the QFT-GIT assay.ConclusionAlthough the IFN-γ level measured by QFT-GIT assay decreased after successful anti-TB treatment in most participants, less than half of them exhibited QFT-GIT reversion. Thus, the reversion to negativity of the QFT-GIT assay may not be a good surrogate for treatment response in otherwise healthy young patients with TB.
Highlights
The role of interferon-g release assay (IGRA) in monitoring responses to anti-tuberculosis (TB) treatment is not clear
To examine the potential of the IGRA as a surrogate for treatment response among young immunocompetent patients with TB, we evaluated the sequential changes in the interferon-gamma (IFN-g) level measured by the QuantiFERON-TB Gold In-tube (QFT-GIT; Cellestis, Victoria, Australia) assay in immunocompetent adults with TB, but with no underlying disease
To diagnose clinical TB, respiratory symptoms and radiographic lesions on high-resolution computed tomography (HRCT) that were compatible with active TB were mandatory
Summary
The role of interferon-g release assay (IGRA) in monitoring responses to anti-tuberculosis (TB) treatment is not clear. We evaluated the results of the QuantiFERON-TB Gold In-tube (QFT-GIT) assay over time during the anti-TB treatment of adults with no underlying disease. Tuberculosis (TB) remains one of the most significant infectious diseases worldwide. Rapid diagnosis and appropriate treatment of TB are important for the health of individuals and for effective disease control in a population. Sputum microscopy is still used, despite its reportedly low sensitivity [2]. The interferon-gamma release assay (IGRA) has recently been adopted for detecting TB infection [3]. Its role in the diagnosis of latent TB infection (LTBI) is
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