Comparison of a Quantiferon-TB Gold In Tube Test With Tuberculin Skin Test in Patients With Active and Latent Tuberculosis Infection

Abstract

Objective: To compare the usefulness and the performance of Quanti FERON-TB Gold Test (QFT-G) assays and tuberculin skin test (TST) in patients with active and latent tuberculosis (TB) disease. Material and Method: Sixteen patients with active, 26 patients with latent TB ve 21 controls were included the study. Blood samples were taken for QFT-GIT before the treatment in patients with active TB and then TST was performed. Results: QFT-GIT tests were positive in 12 (75.0%) of active TB, in 15 (65.2%) of latent TB patients and in 3 (14.3%) controls. QFT-GIT test was found to be significantly higher in active TB patients and in latent TB patients compare to those of controls (respective p=0.003, p=0.005). Sensitivities of QFT-G were found to be as 75% and specificities 85.7% for active TB and 65.2% and 85.7% respectively for latent TB. When patients with active and latent TB were evaluated sensitivities of QFT-GIT were 75% and specificities 34.8%. The mean TST value was statistically higher in latent TB patients than active TB patients (p=0.001) and in active TB patients than controls (p=0.001). A positive correlation was detected between QFT-GIT test and TST. Conclusion: Even it was thought that QFT assays have the supplementary role for detection of active and latent TB, specificity of the test for the diagnostic discrimination between active TB and latent TB disease is low. The presence of positive correlation between QFT-GIT and TST and the high quality of QFN-GIT is taking into account in our.

Keywords

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Aktif ve Latent Tüberkülozlu Olguların Tanısında Tüberkülin Deri Testi ile Quantiferon-TB Gold In Tube Testinin Etkinliğinin Karşılaştırılması

Öz

Amaç: Aktif ve latent tüberkülozu (TB) olan hastalarda QuantiFERON-TB Gold In Tube (QFT-GIT) ve tüberkülin deri testinin (TDT) tanısal değerinin araştırılması ve bu iki testin etkinliğinin karşılaştırılması. Gereç ve Yöntem: Çalışmamıza 16 aktif akciğer, 26 latent TB'li olgu ve 21 sağlıklı kontrol olgu alındı. Aktif akciğer TB'li olgularda tedavi başlanmadan önce olmak üzere tüm olgularda önce QFT- GIT için kan alındı daha sonra TDT'leri uygulandı. Bulgular: QFT-GIT testi aktif TB hastalarının 12'sinde (%75.0), latent TB olgularının 15'inde (%65.2) pozitif iken, kontrol grubunda 3 (%14.3) olguda pozitif sonuç elde edildi. Ortalama QFT-GIT testi düzeyleri hem aktif hem de latent TB olgularında kontrol grubu ile karşılaştırıldığında istatistiksel olarak anlamlı düzeylerde yüksekti (sırasıyla p=0.003, p=0.005). QFT-GIT testinin duyarlılığı ve özgüllüğü aktif akciğer TB'nin saptanmasında %75 ile %85.7, latent TB'nin saptanmasında %65.2 ile %85.7 olarak saptandı. Aktif akciğer ve latent TB'li olgular değerlendirildiğinde ise testin duyarlılığı %75, özgüllüğü %34.8 olarak bulundu. Ortalama TDT endürasyon çapı latent TB'li olgularda aktif akciğer TB'ye göre (p=0.001) ve aktif akciğer TB'li olgularda kontrol grubuna göre (p=0.001) istatiksel olarak yüksek saptandı. QFT-GIT testi ile TDT arasında pozitif korelasyon saptandı. Sonuç: Latent TB infeksiyonu ve aktif TB'lu hastaların saptanmasında, TDT ile karşılaştırıldığında QFT-GIT'in tanıda katkısının olabileceği düşünülse de; testin aktif hastalık ve latent infeksiyon ayırımında özgüllüğü düşmektedir. QFT-GIT ile TDT arasında pozitif korelasyon saptanmış olması ve QFT-GIT'in maliyetinin yüksek olması ise ülkemiz şartlarında dikkate alınmalıdır.

Anahtar Kelimeler

• Aktif akciğer tüberkülozu, latent tüberküloz infeksiyonu, QuantiFERON-TB Gold IT, tüberkülin deri testi

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