HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:
Guest Access | Sign In via User Name/Password

This Article Full Text (PDF) Free All Versions of this Article: chest.06-2805v1 132/3/959    most recent Submit a response Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to My Personal Article Archive Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Kang, Y. A. Articles by Yim, J.-J. Search for Related Content PubMed PubMed Citation Articles by Kang, Y. A. Articles by Yim, J.-J.

Usefulness of whole-blood interferon- assay and interferon- enzyme-linked immunospot assay in the diagnosis of active pulmonary tuberculosis

Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine and Lung Institute, Seoul National University College of Medicine, Seoul, South Korea National Cancer Control Research Institute, National Cancer Center, Goyang, Republic of Korea

yimjj{at}snu.ac.kr

Abstract

BackgroundThe aim of this study was to evaluate the usefulness of the whole-blood interferon- assay (ELISA) and interferon- enzyme-linked immunospot assay (ELISPOT) based on ESAT-6 and CFP-10 in the diagnosis of active pulmonary TB in routine clinical practice.

MethodsWe conducted a prospective study, enrolling 144 participants with suspected pulmonary TB in a tertiary referral hospital in Seoul, South Korea, to investigate the diagnostic sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of the tests. Clinical assessment, Tuberculin skin test (TST), whole-blood interferon- ELISA (QuantiFERON-TB Gold [QFT-G]), and an ELISPOT assay (T SPOT.TB) were performed. The test results were compared with the final confirmed diagnoses.

ResultsOf 144 subjects, 67 (47%) were diagnosed with active pulmonary TB. The sensitivities of the QFT-G, and T SPOT.TB for active pulmonary TB were 89% (95% confidence interval [CI], 79%--96%) and 92% (95% CI, 83%--97%). Their specificities were 49% (95% CI, 37%--61%) and 47% (95% CI, 36%--59%). The NPV of QFT-G (84%, 95% CI; 69%--93%) and T SPOT.TB (87%, 95% CI; 73%--96%) were higher than that of TST (64 %, 95% CI; 51%--76%). (P = 0.001 and P <0.001, respectively)

ConclusionThe high NPV of QFT-G and T SPOT.TB test for the diagnosis of active TB suggests the supplementary role of these tests for the diagnostic exclusion of active TB, although the low PPV limits their usefulness in routine clinical practice in South Korea where the prevalence of latent TB infection is considerable.

Key Words: Tuberculosis • diagnosis • interferon- • ESAT-6 • CFP-10

This article has been cited by other articles:

				C. C. Leung and W. W. Yew Can the Interferon-{gamma} Release Assay Help Diagnose Active Tuberculosis in the Elderly? Chest, August 1, 2008; 134(2): 471 - 471. [Full Text] [PDF]

				J.-P. Janssens Clinical Utility of the Interferon-{gamma} Release Assay for Elderly Patients With Active Tuberculosis: A Word of Caution Chest, August 1, 2008; 134(2): 471 - 472. [Full Text] [PDF]