Winje Brita Askeland, Oftung Fredrik, Korsvold Gro Ellen, Mannsåker Turid, Jeppesen Anette Skistad, Harstad Ingunn, Heier Berit Tafjord, Heldal Einar
Division of Infectious Disease Epidemiology, Norwegian Institute of Public Health, 0403 Oslo, Norway.
BMC Infect Dis. 2008 May 14;8:65. doi: 10.1186/1471-2334-8-65.
QuantiFERONTB Gold (QFT) is a promising blood test for tuberculosis infection but with few data so far from immigrant screening. The aim of this study was to compare results of QFT and tuberculin skin test (TST) among newly arrived asylum seekers in Norway and to assess the role of QFT in routine diagnostic screening for latent tuberculosis infection.
The 1000 asylum seekers (age > or = 18 years) enrolled in the study were voluntarily recruited from 2813 consecutive asylum seekers arriving at the national reception centre from September 2005 to June 2006. Participation included a QFT test and a questionnaire in addition to the mandatory TST and chest X-ray.
Among 912 asylum seekers with valid test results, 29% (264) had a positive QFT test whereas 50% (460) tested positive with TST (indurations > or = 6 mm), indicating a high proportion of latent infection within this group. Among the TST positive participants 50% were QFT negative, whereas 7% of the TST negative participants were QFT positive. There was a significant association between increase in size of TST result and the likelihood of being QFT positive. Agreement between the tests was 71-79% depending on the chosen TST cut-off and it was higher for non-vaccinated individuals.
By using QFT in routine screening, further follow-up could be avoided in 43% of the asylum seekers who would have been referred if based only on a positive TST (> or = 6 mm). The proportion of individuals referred will be the same whether QFT replaces TST or is used as a supplement to confirm a positive TST, but the number tested will vary greatly. All three screening approaches would identify the same proportion (88-89%) of asylum seekers with a positive QFT and/or a TST > or = 15 mm, but different groups will be missed.
QuantiFERON-TB Gold（QFT）是一种用于结核病感染的很有前景的血液检测方法，但目前来自移民筛查的数据很少。本研究的目的是比较挪威新到寻求庇护者中QFT和结核菌素皮肤试验（TST）的结果，并评估QFT在潜伏性结核感染常规诊断筛查中的作用。
本研究纳入的1000名寻求庇护者（年龄≥18岁）是从2005年9月至2006年6月抵达国家接待中心的2813名连续寻求庇护者中自愿招募的。参与研究包括进行QFT检测和问卷调查，此外还包括强制性的TST和胸部X线检查。
在912名有有效检测结果的寻求庇护者中，29%（264名）QFT检测呈阳性，而50%（460名）TST检测呈阳性（硬结≥6mm），表明该群体中潜伏感染比例很高。在TST阳性参与者中，50%的人QFT检测为阴性，而TST阴性参与者中有7%的人QFT检测为阳性。TST结果大小的增加与QFT呈阳性的可能性之间存在显著关联。根据所选的TST临界值，两种检测方法之间的一致性为71%-79%，未接种疫苗的个体一致性更高。
通过在常规筛查中使用QFT，43%仅基于TST阳性（≥6mm）就会被转诊的寻求庇护者可以避免进一步随访。无论QFT是取代TST还是作为确认TST阳性的补充，被转诊个体的比例将是相同的，但检测的人数会有很大差异。所有三种筛查方法将识别出相同比例（88%-89%）的QFT阳性和/或TST≥15mm的寻求庇护者，但会遗漏不同的群体。
