Department of Pneumology, Medical School Hannover (MHH), Carl-Neuberg-Str.1, 30625 Hannover, Germany.
Am J Respir Crit Care Med. 2011 Jan 1;183(1):88-95. doi: 10.1164/rccm.201006-0974OC. Epub 2010 Aug 27.
only limited data are available on the predictive value of interferon-γ release assays for progression from latent tuberculosis infection to active tuberculosis (TB).
to build on our initial study comparing the QuantiFERON-TB Gold in-tube assay (QFT) with the tuberculin skin test (TST) in close contacts of patients with TB and evaluating progression to active TB for up to 4 years.
a cohort of close contacts of smear-positive index cases established between May 2005 and April 2008 was tested with QFT and TST. Through April 2010, progressors to active TB were consecutively recorded.
of the 1,414 contacts (141 children), 1,033 were still resident in Hamburg at the end of the study period, and results of both tests were available for 954. QFT, but not TST, results were associated with exposure time (P < 0.0001). For QFT, 198 of 954 (20.8%) were positive; 63.3% (604) were TST positive at greater than 5 mm and 25.4% at greater than 10 mm. Nine hundred and three contacts refused chemoprevention and 19 developed active TB. All 19 (100%) had been QFT positive with a progression rate of 12.9% (19 of 147) over the observation period. Corresponding values for the TST were significantly lower: 89.5% (17 of 19) and 3.1% (17 of 555) at greater than 5 mm, and 52.6% (10 of 19) and 4.8% (10 of 207) at greater than 10 mm, respectively. The progression rate of 28.6% (6 of 21) for QFT-positive children was significantly higher than 10.3% (13 of 126) for adults (P = 0.03).
results suggest that QFT is more reliable than the TST for identifying those who will soon progress to active TB, especially in children.
仅有有限的数据可用于预测从潜伏性结核感染进展为活动性结核病（TB）的干扰素-γ释放试验的预测值。
在我们最初的研究基础上进行扩展，该研究比较了 QuantiFERON-TB Gold 管内试验（QFT）与结核菌素皮肤试验（TST）在 TB 患者密切接触者中的应用，并评估了 4 年内进展为活动性 TB 的情况。
2005 年 5 月至 2008 年 4 月期间建立了涂片阳性指数病例的密切接触者队列，对其进行 QFT 和 TST 检测。截至 2010 年 4 月，连续记录进展为活动性 TB 的患者。
在 1414 名接触者（141 名儿童）中，1033 名在研究结束时仍居住在汉堡，954 名可获得两项检测的结果。QFT 但不是 TST 结果与暴露时间相关（P < 0.0001）。对于 QFT，954 名中有 198 名（20.8%）阳性；63.3%（604 名）TST 阳性大于 5mm，25.4%大于 10mm。903 名接触者拒绝化学预防，19 名发展为活动性 TB。所有 19 名（100%）QFT 阳性，观察期间的进展率为 12.9%（19 名中的 147 名）。TST 的相应值显著较低：大于 5mm 时为 89.5%（17 名中的 19 名）和 3.1%（17 名中的 555 名），大于 10mm 时为 52.6%（10 名中的 19 名）和 4.8%（10 名中的 207 名）。QFT 阳性儿童的进展率为 28.6%（6 名中的 19 名）显著高于成人的 10.3%（13 名中的 126 名）（P = 0.03）。
结果表明，QFT 比 TST 更可靠地识别出那些即将进展为活动性 TB 的人，尤其是儿童。
