Çavuşoğlu Cengiz, Yaşar-Duman Melike, Sezai Taşbakan Mehmet, Işıkgöz-Taşbakan Meltem, Nurullah Orman Mehmet
Department of Medical Microbiology, University of Ege, Izmir, Turkey.
Department of Chest Diseases, University of Ege, Izmir, Turkey.
J Clin Tuberc Other Mycobact Dis. 2021 Feb 13;23:100223. doi: 10.1016/j.jctube.2021.100223. eCollection 2021 May.
The aim was to evaluate the sensitivity and the possible factors affecting the sensitivity of the QuantiFERON®-TB Gold Plus (QFT-Plus) assay in culture-positive active TB (Tuberculosis) patients, to investigate the possible causes of negative and indeterminate results in active TB patients, and to compare the QFT-Plus results of active TB patients and latent tuberculosis infection (LTBI) cases. The QFT-Plus assay was performed in 46 active TB patients and 64 LTBI. The sensitivity of the test was found as 79.5% in all culture-positive patients, 72.7% in the immunocompromised patients, and 86.4% in the non-immunocompromised patients. Compared to active TB, individuals with LTBI had a lower T-cell response and lower IFN-ɣ concentrations. It was determined that the immunocompromisation reduced the sensitivity of the test and the secreted IFN-ɣ concentrations and increased the indeterminate results in patients with active TB. There was no difference in secreted IFN-ɣ concentrations between M. tuberculosis clones, but higher IFN-ɣ concentrations in patients infected with M. tuberculosis strains compared to patients infected with zoonotic strains. Compared with active TB, response to "only to TB2" was significantly higher in LTBI. In conclusion, it was concluded that TB2 tube increased sensitivity in LTBI but may not contribute to sensitivity in active TB.
目的是评估结核感染T细胞检测金标升级版(QFT-Plus)检测在培养阳性的活动性肺结核患者中的敏感性以及影响其敏感性的可能因素,调查活动性肺结核患者检测结果为阴性和不确定的可能原因,并比较活动性肺结核患者与潜伏性结核感染(LTBI)病例的QFT-Plus检测结果。对46例活动性肺结核患者和64例LTBI患者进行了QFT-Plus检测。在所有培养阳性患者中,该检测的敏感性为79.5%,在免疫功能低下患者中为72.7%,在非免疫功能低下患者中为86.4%。与活动性肺结核相比,LTBI个体的T细胞反应较低,干扰素-γ浓度也较低。研究确定,免疫功能低下会降低检测的敏感性和分泌的干扰素-γ浓度,并增加活动性肺结核患者检测结果不确定的情况。结核分枝杆菌克隆之间分泌的干扰素-γ浓度没有差异,但与感染人畜共患菌株的患者相比,感染结核分枝杆菌菌株的患者干扰素-γ浓度更高。与活动性肺结核相比,LTBI患者对“仅针对TB2”的反应明显更高。总之,得出的结论是,TB2管提高了LTBI的敏感性,但可能对活动性肺结核的敏感性没有帮助。