Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine and Lung Institute, Seoul National University College of Medicine, Seoul, Republic of Korea.
BMC Infect Dis. 2010 Oct 16;10:300. doi: 10.1186/1471-2334-10-300.
The 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.
We 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.
Of 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.
Although 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.
干扰素-γ释放试验（IGRA）在监测抗结核（TB）治疗反应中的作用尚不清楚。我们评估了无基础疾病的成人接受抗 TB 治疗期间 QFT-GIT 检测的结果随时间的变化。
我们招募了 2008 年 5 月 1 日至 2009 年 9 月 30 日期间在韩国中央转诊军事医院新诊断为活动性 TB 并入院的士兵。对于每个参与者，我们在治疗前（基线）和开始抗 TB 药物治疗后 1、3 和 6 个月进行 QFT-GIT 检测。
67 名符合条件的患者中，59 名（88.1%）完成了研究方案。所有参与者均为男性，HIV 阴性且无慢性疾病。他们的中位年龄为 21 岁（范围，20-48 岁）。最初，57 名（96.6%）患者 QFT-GIT 检测结果阳性，分别有 53（89.8%）、42（71.2%）和 39（66.1%）名患者在治疗后 1、3 和 6 个月 QFT-GIT 检测结果转为阴性。基线时 IFN-γ 水平为 5.31 ± 5.34 IU/ml，1、3 和 6 个月时 IFN-γ 水平分别为 3.95 ± 4.30、1.82 ± 2.14 和 1.50 ± 2.12 IU/ml。所有患者经治疗后临床和影像学均有改善，治愈。治疗后 IFN-γ 水平较低、C 反应蛋白≥3mg/dl 和发热（≥38.3°C）与 QFT-GIT 检测结果的阴转有关。
虽然大多数参与者接受成功的抗 TB 治疗后 QFT-GIT 检测的 IFN-γ 水平下降，但不到一半的参与者 QFT-GIT 检测结果转为阴性。因此，对于无基础疾病的年轻结核病患者，QFT-GIT 检测结果的阴转可能不是治疗反应的良好替代指标。
