QuantiFERON-TB test; interferon gamma release assay (IGRA)

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Indications

* otherwise tuberculin skin testing is recommended[9]

* more specific than tuberculin skin testing in patients with a history of BCG vaccination

* the BCG vaccine does not affect QuantiFERON-TB test results[15]

Contraindications

* once positive, test remains positive after treatment for active tuberculosis or latent tuberculosis

Advantages

Disadvantages

* no association between test conversion & exposure to tuberculosis[12]

Principle

FDA-approved.

Methods

includes positive control

Management

More general terms

Additional terms

References

  1. Journal Watch 21(23):185, 2001 Mazurek GH et al Comparison of a whole-blood interferon gamma assay with tuberculin skin testing for detecting latent Mycobacterium tuberculosis infection. JAMA 286:1740, 2001 PMID: https://www.ncbi.nlm.nih.gov/pubmed/11594899
  2. Mazurek GH, Villarino ME; CDC. Guidelines for using the QuantiFERON-TB test for diagnosing latent Mycobacterium tuberculosis infection. Centers for Disease Control and Prevention. MMWR Recomm Rep. 2003 Jan 31;52(RR-2):15-8. PMID: https://www.ncbi.nlm.nih.gov/pubmed/12583541
    Gerberding JL et al, MMWR 2005; 54/RR-15:1 The Centers for Disease Control and Prevention (CDC) Guidelines for using the QuantiFERON-TB Gold test for detecting Mycobacterium tuberculosis infection, United States http://www.cdc.gov/mmwr/PDF/rr/rr5415.pdf
  3. Ferrara G et al, Use in routine clinical practice of two commercial blood tests for diagnosis of infection with Mycobacterium tuberculosis. Lancet 2006; 367:1328 PMID: https://www.ncbi.nlm.nih.gov/pubmed/16631911
  4. de Perio MA et al Cost-effectiveness of interferon gamma release assays vs tuberculin skin tests in health care workers. Arch Intern Med 2009 Jan 26; 169:179. PMID: https://www.ncbi.nlm.nih.gov/pubmed/19171815
  5. Cellestis Limited, Carnegie, Victoria, Australia
  6. 6.0 6.1 Diel R et al. Negative and positive predictive value of a whole-blood interferon-gamma-release assay for developing active tuberculosis: An update. Am J Respir Crit Care Med 2011 Jan 1; 183:88 PMID: https://www.ncbi.nlm.nih.gov/pubmed/20802162
    Lange C and Rieder HL. Intention to test is intention to treat. Am J Respir Crit Care Med 2011 Jan 1; 183:3. PMID: https://www.ncbi.nlm.nih.gov/pubmed/21193782
  7. 7.0 7.1 Fong KS et al. Challenges of interferon-gamma release assay conversions in serial testing of health-care workers in a TB control program. Chest 2012 Jul 1; 142:55. PMID: https://www.ncbi.nlm.nih.gov/pubmed/22796839
    Diel R, Loddenkemper R, Nienhaus A. Predictive value of interferon-gamma release assays and tuberculin skin testing for progression from latent TB infection to disease state: a meta-analysis. Chest. 2012 Jul;142(1):63-75 PMID: https://www.ncbi.nlm.nih.gov/pubmed/22490872
    Loddenkemper R, Diel R, Nienhaus A. To repeat or not to repeat-that is the question!: Serial testing of health-care workers for TB infection. Chest. 2012 Jul;142(1):10-1. doi:http://dx.doi.org/ 10.1378/chest.12-0045. PMID: https://www.ncbi.nlm.nih.gov/pubmed/22796831
  8. 8.0 8.1 Mazurek GH, Jereb J, Vernon A, LoBue P et al Updated guidelines for using Interferon Gamma Release Assays to detect Mycobacterium tuberculosis infection - United States, 2010. MMWR Recomm Rep. 2010 Jun 25;59(RR-5):1-25. PMID: https://www.ncbi.nlm.nih.gov/pubmed/20577159 corresponding NGC guideline withdrawn Jan 2016
  9. 9.0 9.1 9.2 9.3 9.4 Medical Knowledge Self Assessment Program (MKSAP) 16, 17 American College of Physicians, Philadelphia 2012, 2015
  10. Ponce de Leon D, Acevedo-Vasquez E, Alvizuri S et al Comparison of an interferon-gamma assay with tuberculin skin testing for detection of tuberculosis (TB) infection in patients with rheumatoid arthritis in a TB-endemic population. J Rheumatol. 2008 May;35(5):776-81. Epub 2008 Apr 1. PMID: https://www.ncbi.nlm.nih.gov/pubmed/18398944
  11. 11.0 11.1 Slater ML et al. Challenges with QuantiFERON-TB gold assay for large-scale, routine screening of U.S. healthcare workers. Am J Respir Crit Care Med 2013 Oct 15; 188:1005 PMID: https://www.ncbi.nlm.nih.gov/pubmed/23978270
  12. 12.0 12.1 12.2 12.3 Dorman SE et al. Interferon-gamma release assays and tuberculin skin testing for diagnosis of latent tuberculosis infection in healthcare workers in the United States. Am J Respir Crit Care Med 2014 Jan 1; 189:77 PMID: https://www.ncbi.nlm.nih.gov/pubmed/24299555
  13. McMullen SE et al. Performance of QuantiFERON-TB Gold and tuberculin skin test relative to subjects' risk of exposure to tuberculosis. Clin Infect Dis 2014 May 1; 58 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/24585559 <Internet> http://cid.oxfordjournals.org/content/58/9/1260
  14. Centers for Disease Control and Prevention Interferon-Gamma Release Assays (IGRAs) - Blood Tests for TB Infection. http://www.cdc.gov/tb/publications/factsheets/testing/igra.htm
  15. 15.0 15.1 Yamcy JR, Melchert VE QuantiFERON-TB Gold+ for the Diagnosis of Mycobacterium tuberculosis Infection American Family Physician 2021. Feb 1;103(3):177-178 PMID: https://www.ncbi.nlm.nih.gov/pubmed/33507050 https://www.aafp.org/pubs/afp/issues/2021/0201/p177.html#afp20210201p177-b6
    Haas MK, Belknap RW. Diagnostic tests for latent tuberculosis infection. Clin Chest Med. 2019;40(4):829-837 PMID: https://www.ncbi.nlm.nih.gov/pubmed/31731987