Smoking is a Factor in Discordance Between QuantiFERONTB Gold Assay and Tuberculosis Etiology: Especially in Older Patients
Libin Liu,1,2,* Guihua Wu,1,2 Jing Wang,1,2 Lijun Peng,1,2 Xiaoqun Xu,1,2 Long Cai1,2,* 1Centre of Laboratory Medicine, Affiliated Hangzhou Chest Hospital, Zhejiang University School of Medicine, Hangzhou, People’s Republic of China; 2Centre of Laboratory Medicine, Hangzhou Red Cross...
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Dove Medical Press
2023-06-01
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| Series: | Infection and Drug Resistance |
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| Online Access: | https://www.dovepress.com/smoking-is-a-factor-in-discordance-between-quantiferontb-gold-assay-an-peer-reviewed-fulltext-article-IDR |
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| author | Liu L Wu G Wang J Peng L Xu X Cai L |
| author_facet | Liu L Wu G Wang J Peng L Xu X Cai L |
| author_sort | Liu L |
| collection | DOAJ |
| description | Libin Liu,1,2,* Guihua Wu,1,2 Jing Wang,1,2 Lijun Peng,1,2 Xiaoqun Xu,1,2 Long Cai1,2,* 1Centre of Laboratory Medicine, Affiliated Hangzhou Chest Hospital, Zhejiang University School of Medicine, Hangzhou, People’s Republic of China; 2Centre of Laboratory Medicine, Hangzhou Red Cross Hospital, Hangzhou, Zhejiang, People’s Republic of China*These authors contributed equally to this workCorrespondence: Long Cai, Centre of Laboratory Medicine, Affiliated Hangzhou Chest Hospital, Zhejiang University School of Medicine, No. 208 East Huancheng Road, Hangzhou, 310003, People’s Republic of China, Email cailong317@hotmail.comPurpose: Exploring whether smoking is an influencing factor for the inconsistency between QuantiFERONTB Gold assay (QFT-GIT) and tuberculosis etiology.Patients and Methods: The clinical data of patients who were confirmed positive for Mycobacterium tuberculosis (MTB) after undergoing QFT-GIT testing from September 2017 to August 2021 were retrospectively analyzed. Chi-square and rank-sum tests were used to compare the differences in characteristics between smokers and non-smokers. Logistic regression was used to adjust for confounding factors affecting smoking. Propensity score matching (PSM) was used to verify the above conclusions again.Results: Positive results of tuberculosis etiology were adopted as the standard, the incidence of inconsistent results between QFT-GIT and tuberculosis etiology was 8.90% (108/1213), of which the false negative rate was 6.27% (76/1213) and the indeterminate rate was 2.64% (32/1213). In the overall population, the smokers had a lower level of basal IFN-γ (Z=− 2.079, P=0.038). Among 382 elderly (≥ 65 years old) patients, the smokers had lower levels of antigen-stimulated IFN-γ (Z=− 2.838, P=0.005). After performing BOX-COX transformation on all non-normally distributed data, logistic stepwise regression was used to adjust confounding factors. The results showed that smoking was an influencing factor for the inconsistency between QFT-GIT and tuberculosis etiology results (OR=1.69, P=0.020). Using PSM for 1:2 matching, the results showed that smoking was still an independent risk factor for the inconsistent results of QFT-GIT and tuberculosis etiology (OR= 1.95, P=0.019). Age-stratified analysis showed that smoking was an independent risk factor in discordance between QFT-GIT and tuberculosis etiology in patients aged ≥ 65 years (OR=2.40, P=0.005), but not in patients aged < 65 years (P > 0.05).Conclusion: Smoking can reduce the body’s IFN-γ release ability, and smoking (especially the elderly) is an influencing factor for the inconsistency between QFT-GIT and tuberculosis etiological results.Keywords: tuberculosis etiology, PSM, inconsistency, influencing factors |
| first_indexed | 2024-03-13T08:00:54Z |
| format | Article |
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| issn | 1178-6973 |
| language | English |
| last_indexed | 2024-03-13T08:00:54Z |
| publishDate | 2023-06-01 |
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| series | Infection and Drug Resistance |
| spelling | doaj.art-2ac4b044b64c43afb9ad2261ed24c7032023-06-01T16:35:13ZengDove Medical PressInfection and Drug Resistance1178-69732023-06-01Volume 163443345184144Smoking is a Factor in Discordance Between QuantiFERONTB Gold Assay and Tuberculosis Etiology: Especially in Older PatientsLiu LWu GWang JPeng LXu XCai LLibin Liu,1,2,* Guihua Wu,1,2 Jing Wang,1,2 Lijun Peng,1,2 Xiaoqun Xu,1,2 Long Cai1,2,* 1Centre of Laboratory Medicine, Affiliated Hangzhou Chest Hospital, Zhejiang University School of Medicine, Hangzhou, People’s Republic of China; 2Centre of Laboratory Medicine, Hangzhou Red Cross Hospital, Hangzhou, Zhejiang, People’s Republic of China*These authors contributed equally to this workCorrespondence: Long Cai, Centre of Laboratory Medicine, Affiliated Hangzhou Chest Hospital, Zhejiang University School of Medicine, No. 208 East Huancheng Road, Hangzhou, 310003, People’s Republic of China, Email cailong317@hotmail.comPurpose: Exploring whether smoking is an influencing factor for the inconsistency between QuantiFERONTB Gold assay (QFT-GIT) and tuberculosis etiology.Patients and Methods: The clinical data of patients who were confirmed positive for Mycobacterium tuberculosis (MTB) after undergoing QFT-GIT testing from September 2017 to August 2021 were retrospectively analyzed. Chi-square and rank-sum tests were used to compare the differences in characteristics between smokers and non-smokers. Logistic regression was used to adjust for confounding factors affecting smoking. Propensity score matching (PSM) was used to verify the above conclusions again.Results: Positive results of tuberculosis etiology were adopted as the standard, the incidence of inconsistent results between QFT-GIT and tuberculosis etiology was 8.90% (108/1213), of which the false negative rate was 6.27% (76/1213) and the indeterminate rate was 2.64% (32/1213). In the overall population, the smokers had a lower level of basal IFN-γ (Z=− 2.079, P=0.038). Among 382 elderly (≥ 65 years old) patients, the smokers had lower levels of antigen-stimulated IFN-γ (Z=− 2.838, P=0.005). After performing BOX-COX transformation on all non-normally distributed data, logistic stepwise regression was used to adjust confounding factors. The results showed that smoking was an influencing factor for the inconsistency between QFT-GIT and tuberculosis etiology results (OR=1.69, P=0.020). Using PSM for 1:2 matching, the results showed that smoking was still an independent risk factor for the inconsistent results of QFT-GIT and tuberculosis etiology (OR= 1.95, P=0.019). Age-stratified analysis showed that smoking was an independent risk factor in discordance between QFT-GIT and tuberculosis etiology in patients aged ≥ 65 years (OR=2.40, P=0.005), but not in patients aged < 65 years (P > 0.05).Conclusion: Smoking can reduce the body’s IFN-γ release ability, and smoking (especially the elderly) is an influencing factor for the inconsistency between QFT-GIT and tuberculosis etiological results.Keywords: tuberculosis etiology, PSM, inconsistency, influencing factorshttps://www.dovepress.com/smoking-is-a-factor-in-discordance-between-quantiferontb-gold-assay-an-peer-reviewed-fulltext-article-IDRtuberculosis etiologypsminconsistencyinfluencing factors |
| spellingShingle | Liu L Wu G Wang J Peng L Xu X Cai L Smoking is a Factor in Discordance Between QuantiFERONTB Gold Assay and Tuberculosis Etiology: Especially in Older Patients Infection and Drug Resistance tuberculosis etiology psm inconsistency influencing factors |
| title | Smoking is a Factor in Discordance Between QuantiFERONTB Gold Assay and Tuberculosis Etiology: Especially in Older Patients |
| title_full | Smoking is a Factor in Discordance Between QuantiFERONTB Gold Assay and Tuberculosis Etiology: Especially in Older Patients |
| title_fullStr | Smoking is a Factor in Discordance Between QuantiFERONTB Gold Assay and Tuberculosis Etiology: Especially in Older Patients |
| title_full_unstemmed | Smoking is a Factor in Discordance Between QuantiFERONTB Gold Assay and Tuberculosis Etiology: Especially in Older Patients |
| title_short | Smoking is a Factor in Discordance Between QuantiFERONTB Gold Assay and Tuberculosis Etiology: Especially in Older Patients |
| title_sort | smoking is a factor in discordance between quantiferontb gold assay and tuberculosis etiology especially in older patients |
| topic | tuberculosis etiology psm inconsistency influencing factors |
| url | https://www.dovepress.com/smoking-is-a-factor-in-discordance-between-quantiferontb-gold-assay-an-peer-reviewed-fulltext-article-IDR |
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