Department of Respiratory Medicine, Showa University Fujigaoka Hospital, Yokohama, Japan.
Department of Respiratory Medicine, Showa University Fujigaoka Hospital, 1-30 Fujigaoka, Aoba-ku, Yokohama 227-8501, Japan.
Ther Adv Respir Dis. 2022 Jan-Dec;16:17534666221077817. doi: 10.1177/17534666221077817.
The interferon (IFN)-γ release assay (IGRA) has recently been established as a method to evaluate the infection status of tuberculosis instead of the tuberculin skin test. However, indeterminate results can create challenges to interpretation. The IGRA has been available in Japan since 2005, including the recently launched QuantiFERON-TB Gold Plus (QFT-plus) assay.
The aim of this study was to investigate the clinical features and predictors of indeterminate results by the QFT-plus test in routine practice.
This was a cross-sectional study of 1258 patients. Multivariate logistic regression models were employed to investigate the clinical factors related to indeterminate results by the QFT-plus.
Overall, 91.8% of results were found to be conclusive and 8.2% were indeterminate. The QFT-plus indeterminate results were predominantly due to a low level of IFN-γ production by mitogens. Multivariate analysis indicated that an indeterminate result was significantly associated with age, sex, corticosteroid use, autoimmune disease, and inpatient setting.
Certain types of individuals are at higher risk of an indeterminate IGRA result. The QFT-plus test for hospitalized patients should be avoided as much as possible, and it is better to perform the test for those patients in outpatient settings.
干扰素（IFN）-γ释放试验（IGRA）最近已被确立为评估结核病感染状态的方法，而非结核菌素皮肤试验。然而，不确定的结果可能会对解释造成挑战。IGRA 自 2005 年在日本推出，包括最近推出的 QuantiFERON-TB Gold Plus（QFT-plus）检测。
本研究旨在调查常规实践中 QFT-plus 试验不确定结果的临床特征和预测因素。
这是一项对 1258 例患者的横断面研究。采用多变量逻辑回归模型来研究与 QFT-plus 不确定结果相关的临床因素。
总体而言，91.8%的结果是确定的，8.2%是不确定的。QFT-plus 不确定结果主要是由于有丝分裂原刺激的 IFN-γ 产生水平较低。多变量分析表明，不确定结果与年龄、性别、皮质类固醇使用、自身免疫性疾病和住院环境显著相关。
某些类型的个体更有可能出现不确定的 IGRA 结果。应尽可能避免对住院患者进行 QFT-plus 检测，最好在门诊环境下对这些患者进行检测。
