Phetsuksiri Benjawan, Srisungngam Sopa, Rudeeaneksin Janisara, Boonchu Supranee, Klayut Wiphat, Norrarat Ronnayuth, Sangkitporn Somchai, Kasetjaroen Yuthichai
Ministry of Public Health, National Institute of Health, Department of Medical Sciences, Nonthaburi, Thailand.
Ministry of Public Health, Department of Disease Control, Bureau of Tuberculosis, Bangkok, Thailand.
Rev Inst Med Trop Sao Paulo. 2018 Oct 22;60:e56. doi: 10.1590/S1678-9946201860056.
Interferon-gamma (IFN-γ) release assays have improved latent tuberculosis (TB) detection and have been considered promising for the diagnosis of TB disease. However, diagnosis efficacy data is limited in high burden countries. The aim of this study was to determine the diagnostic potential of the QuantiFERON-TB Gold In-Tube (QFT-GIT) test for the diagnosis of active TB in an endemic setting for TB. A cross-sectional study was conducted in a group of 102 Thai patients with clinical symptoms and chest x-ray findings suggesting of active pulmonary TB and a group of 112 healthy adults. Testing was carried out using sputum microscopy, mycobacterial culture and QFT-GIT test. Of these patients, QFT-GIT was positive in 73 (71.57%), negative in 27 (26.47%), and undetermined in 2 (1.96%) cases. Among healthy controls, QFT-GIT was positive in 18 (16.07%), negative in 93 (83.04%), and undetermined in 1 (0.89%) person. Based on TB culture results, the sensitivity of QFTGIT for diagnosing active TB was 84.21% (95% confidence interval (CI); 72.13-92.52). The positive and negative predictive values were 65.75% (95% CI; 59.26-71.70) and 66.67% (95% CI; 49.94-80.04), respectively. The median IFN-γ level in culture-confirmed TB patients was 3.91 compared to 0.03 IU/mL of the healthy group. QFT-GIT appears to be a useful indirect test for TB diagnosis in Thailand and its use is recommended in association with clinical and radiological assessments for identifying active or latent TB.
干扰素-γ（IFN-γ）释放试验已改善了潜伏性结核病（TB）的检测，并被认为在结核病诊断方面很有前景。然而，在高负担国家，诊断效能数据有限。本研究的目的是确定在结核病流行地区，管内QuantiFERON-TB金标试验（QFT-GIT）对活动性结核病诊断的潜力。对一组102名有临床症状且胸部X光检查结果提示活动性肺结核的泰国患者以及一组112名健康成年人进行了横断面研究。使用痰涂片显微镜检查、分枝杆菌培养和QFT-GIT试验进行检测。在这些患者中，QFT-GIT试验结果为阳性的有73例（71.57%），阴性的有27例（26.47%），不确定的有2例（1.96%）。在健康对照者中，QFT-GIT试验结果为阳性的有18例（16.07%），阴性的有93例（83.04%），不确定的有1例（0.89%）。根据结核培养结果，QFT-GIT诊断活动性结核病的敏感性为84.21%（95%置信区间（CI）；72.13 - 92.52）。阳性和阴性预测值分别为65.75%（95% CI；59.26 - 71.70）和66.67%（95% CI；49.94 - 80.04）。培养确诊的结核病患者中，IFN-γ水平的中位数为3.91，而健康组为0.03 IU/mL。QFT-GIT似乎是泰国结核病诊断的一种有用的间接检测方法，建议将其与临床和放射学评估相结合用于识别活动性或潜伏性结核病。
