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结核分枝杆菌潜伏感染者干扰素释放试验结果转化时间。

Time interval to conversion of interferon-gamma release assay after exposure to tuberculosis.

机构信息

Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Armed Forces Capital Hospital, Lung Institute, Seoul National University College of Medicine, 101 Daehangno, Jongno-gu, Seoul, 110-744, Republic of Korea.

出版信息

Eur Respir J. 2011 Jun;37(6):1447-52. doi: 10.1183/09031936.00089510. Epub 2010 Dec 9.

Abstract

The proper interval for repeating an interferon-γ release assay (IGRA) among tuberculosis contacts with initially negative results is unknown. The interval for IGRA conversion after exposure to patients with active pulmonary tuberculosis in an outbreak setting was evaluated. In a platoon of 32 soldiers, four active pulmonary tuberculosis patients, in addition to one index patient, were diagnosed during a contact investigation. For the other 27 contacts, a tuberculin skin test (TST) and QuantiFERON® TB-Gold In-Tube (QFT-GIT) assay were performed. For soldiers with a negative result on the initial QFT-GIT assay, the test was repeated at 2, 4, 8, 14, 18 and 30 weeks until positive conversion occurred. When conversion was identified, the subject was treated for latent tuberculosis infection. Initially, 17 (63.0%) soldiers gave positive QFT-GIT results, whereas 21 (77.8%) showed positive TST results. Among 10 participants with initially negative QFT-GIT results, three showed conversion at 2 weeks, three at 4 weeks and three at 14 weeks. Conversion did not occur during the 30-week observation period in one contact. Based on the tuberculosis exposure time-points among the contacts, IGRA conversion generally occurred 4-7 weeks after exposure, although it could occur as late as 14-22 weeks after exposure.

摘要

在最初结果为阴性的结核接触者中重复干扰素-γ释放试验(IGRA)的适当间隔时间尚不清楚。本研究评估了在暴发环境中接触活动期肺结核患者后 IGRA 转化的间隔时间。在一个 32 人的排中,除了一名索引病例外,在接触者调查期间还诊断出 4 例活动性肺结核患者。对于其他 27 名接触者,进行了结核菌素皮肤试验(TST)和 QuantiFERON® TB-Gold In-Tube(QFT-GIT)检测。对于初次 QFT-GIT 检测结果为阴性的士兵,在 2、4、8、14、18 和 30 周时重复检测,直到出现阳性转化。当出现转化时,对潜伏性结核感染的受试者进行治疗。最初,17 名(63.0%)士兵的 QFT-GIT 检测结果为阳性,而 21 名(77.8%)士兵的 TST 检测结果为阳性。在 10 名最初 QFT-GIT 检测结果为阴性的参与者中,3 名在 2 周时出现转化,3 名在 4 周时出现转化,3 名在 14 周时出现转化。在一名接触者中,在 30 周的观察期间未发生转化。根据接触者的结核暴露时间点,IGRA 转化通常发生在暴露后 4-7 周,但也可能在暴露后 14-22 周发生。

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