A toolbox for tuberculosis (TB) diagnosis: an Indian multicentric study (2006-2008). Evaluation of QuantiFERON-TB gold in tube for TB diagnosis.

BACKGROUND: The aim of this multicentric prospective study in India was to assess the performance of the QuantiFERON TB-Gold in tube (QFT-GIT), Tuberculin Skin Test (TST) and microbiological results as additional tools for diagnosing active tuberculosis (TB) and latent infection (LTBI) according to...

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Main Authors: Philippe H Lagrange, Satheesh K Thangaraj, Rajeshwar Dayal, Alaka Deshpande, Nirmal K Ganguly, Enrico Girardi, Beenu Joshi, Kiran Katoch, Vishwa M Katoch, Manoj Kumar, Vemu Lakshmi, Marc Leportier, Christophe Longuet, Subbalaxmi V S Malladi, Deepali Mukerjee, Deepthi Nair, Alamelu Raja, Balambal Raman, Camilla Rodrigues, Pratibha Sharma, Amit Singh, Sarman Singh, Archana Sodha, Basirudeen Syed Ahamed Kabeer, Guy Vernet, Delia Goletti
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2013-01-01
Series:PLoS ONE
Online Access:http://europepmc.org/articles/PMC3765270?pdf=render
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author Philippe H Lagrange
Satheesh K Thangaraj
Rajeshwar Dayal
Alaka Deshpande
Nirmal K Ganguly
Enrico Girardi
Beenu Joshi
Kiran Katoch
Vishwa M Katoch
Manoj Kumar
Vemu Lakshmi
Marc Leportier
Christophe Longuet
Subbalaxmi V S Malladi
Deepali Mukerjee
Deepthi Nair
Alamelu Raja
Balambal Raman
Camilla Rodrigues
Pratibha Sharma
Amit Singh
Sarman Singh
Archana Sodha
Basirudeen Syed Ahamed Kabeer
Guy Vernet
Delia Goletti
author_facet Philippe H Lagrange
Satheesh K Thangaraj
Rajeshwar Dayal
Alaka Deshpande
Nirmal K Ganguly
Enrico Girardi
Beenu Joshi
Kiran Katoch
Vishwa M Katoch
Manoj Kumar
Vemu Lakshmi
Marc Leportier
Christophe Longuet
Subbalaxmi V S Malladi
Deepali Mukerjee
Deepthi Nair
Alamelu Raja
Balambal Raman
Camilla Rodrigues
Pratibha Sharma
Amit Singh
Sarman Singh
Archana Sodha
Basirudeen Syed Ahamed Kabeer
Guy Vernet
Delia Goletti
author_sort Philippe H Lagrange
collection DOAJ
description BACKGROUND: The aim of this multicentric prospective study in India was to assess the performance of the QuantiFERON TB-Gold in tube (QFT-GIT), Tuberculin Skin Test (TST) and microbiological results as additional tools for diagnosing active tuberculosis (TB) and latent infection (LTBI) according to Human Immunodeficiency Virus (HIV) status. METHODS: Individuals with and without active TB and HIV infection were enrolled between 2006-2008. QFT-GIT and TST results were analyzed per se and in combination with microbiological data. RESULTS: Among the 276 individuals (96 active pulmonary TB and 180 no active TB) tested by QFT-GIT, 18 indeterminate results (6.5%) were found, more significantly numerous in the HIV-infected (15/92; 16.3%) than the HIV-uninfected (3/184; 1.6%)(p<0.0001). QFT-GIT sensitivity for active TB was 82.3% and 92.9% respectively after including or excluding indeterminate results. Clinical sensitivity was significantly lower in the HIV-infected (68.4%) than the HIV-uninfected (91.4%) patients (p = 0.0059). LTBI was detected in 49.3% of subjects without active TB but varied according to TB exposure. When the TST and QFT-GIT were concomitantly performed, the respective sensitivity for active TB diagnosis was 95.0% and 85.0% in the HIV-uninfected (p = 0.60), and 66.7% and 51.5% in the HIV-infected patients (p = 0.32). QFT-GIT and TST respective specificity for active TB in the HIV-uninfected was 25.0% and 57.1% (p = 0.028), and 64.8% and 83.3% in the HIV-infected (p = 0.047). In those with active TB, QFT-GIT results were not associated with microbiological parameters (smear grade, liquid culture status, time-to-positivity of culture) or clinical suspicion of active TB score (provided by the clinicians at enrollment). Combining microbiological tests with both immunological tests significantly increased sensitivity for active TB diagnosis (p = 0.0002), especially in the HIV-infected individuals (p = 0.0016). CONCLUSION: QFT-GIT and TST have similar diagnostic value for active TB diagnosis. In HIV-infected patients, combining microbiological tests with both immunological tests significantly increases the sensitivity for active TB diagnosis.
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spelling doaj.art-419b422b6163426c95d99d21deb4da2b2022-12-22T00:57:38ZengPublic Library of Science (PLoS)PLoS ONE1932-62032013-01-0189e7357910.1371/journal.pone.0073579A toolbox for tuberculosis (TB) diagnosis: an Indian multicentric study (2006-2008). Evaluation of QuantiFERON-TB gold in tube for TB diagnosis.Philippe H LagrangeSatheesh K ThangarajRajeshwar DayalAlaka DeshpandeNirmal K GangulyEnrico GirardiBeenu JoshiKiran KatochVishwa M KatochManoj KumarVemu LakshmiMarc LeportierChristophe LonguetSubbalaxmi V S MalladiDeepali MukerjeeDeepthi NairAlamelu RajaBalambal RamanCamilla RodriguesPratibha SharmaAmit SinghSarman SinghArchana SodhaBasirudeen Syed Ahamed KabeerGuy VernetDelia GolettiBACKGROUND: The aim of this multicentric prospective study in India was to assess the performance of the QuantiFERON TB-Gold in tube (QFT-GIT), Tuberculin Skin Test (TST) and microbiological results as additional tools for diagnosing active tuberculosis (TB) and latent infection (LTBI) according to Human Immunodeficiency Virus (HIV) status. METHODS: Individuals with and without active TB and HIV infection were enrolled between 2006-2008. QFT-GIT and TST results were analyzed per se and in combination with microbiological data. RESULTS: Among the 276 individuals (96 active pulmonary TB and 180 no active TB) tested by QFT-GIT, 18 indeterminate results (6.5%) were found, more significantly numerous in the HIV-infected (15/92; 16.3%) than the HIV-uninfected (3/184; 1.6%)(p<0.0001). QFT-GIT sensitivity for active TB was 82.3% and 92.9% respectively after including or excluding indeterminate results. Clinical sensitivity was significantly lower in the HIV-infected (68.4%) than the HIV-uninfected (91.4%) patients (p = 0.0059). LTBI was detected in 49.3% of subjects without active TB but varied according to TB exposure. When the TST and QFT-GIT were concomitantly performed, the respective sensitivity for active TB diagnosis was 95.0% and 85.0% in the HIV-uninfected (p = 0.60), and 66.7% and 51.5% in the HIV-infected patients (p = 0.32). QFT-GIT and TST respective specificity for active TB in the HIV-uninfected was 25.0% and 57.1% (p = 0.028), and 64.8% and 83.3% in the HIV-infected (p = 0.047). In those with active TB, QFT-GIT results were not associated with microbiological parameters (smear grade, liquid culture status, time-to-positivity of culture) or clinical suspicion of active TB score (provided by the clinicians at enrollment). Combining microbiological tests with both immunological tests significantly increased sensitivity for active TB diagnosis (p = 0.0002), especially in the HIV-infected individuals (p = 0.0016). CONCLUSION: QFT-GIT and TST have similar diagnostic value for active TB diagnosis. In HIV-infected patients, combining microbiological tests with both immunological tests significantly increases the sensitivity for active TB diagnosis.http://europepmc.org/articles/PMC3765270?pdf=render
spellingShingle Philippe H Lagrange
Satheesh K Thangaraj
Rajeshwar Dayal
Alaka Deshpande
Nirmal K Ganguly
Enrico Girardi
Beenu Joshi
Kiran Katoch
Vishwa M Katoch
Manoj Kumar
Vemu Lakshmi
Marc Leportier
Christophe Longuet
Subbalaxmi V S Malladi
Deepali Mukerjee
Deepthi Nair
Alamelu Raja
Balambal Raman
Camilla Rodrigues
Pratibha Sharma
Amit Singh
Sarman Singh
Archana Sodha
Basirudeen Syed Ahamed Kabeer
Guy Vernet
Delia Goletti
A toolbox for tuberculosis (TB) diagnosis: an Indian multicentric study (2006-2008). Evaluation of QuantiFERON-TB gold in tube for TB diagnosis.
PLoS ONE
title A toolbox for tuberculosis (TB) diagnosis: an Indian multicentric study (2006-2008). Evaluation of QuantiFERON-TB gold in tube for TB diagnosis.
title_full A toolbox for tuberculosis (TB) diagnosis: an Indian multicentric study (2006-2008). Evaluation of QuantiFERON-TB gold in tube for TB diagnosis.
title_fullStr A toolbox for tuberculosis (TB) diagnosis: an Indian multicentric study (2006-2008). Evaluation of QuantiFERON-TB gold in tube for TB diagnosis.
title_full_unstemmed A toolbox for tuberculosis (TB) diagnosis: an Indian multicentric study (2006-2008). Evaluation of QuantiFERON-TB gold in tube for TB diagnosis.
title_short A toolbox for tuberculosis (TB) diagnosis: an Indian multicentric study (2006-2008). Evaluation of QuantiFERON-TB gold in tube for TB diagnosis.
title_sort toolbox for tuberculosis tb diagnosis an indian multicentric study 2006 2008 evaluation of quantiferon tb gold in tube for tb diagnosis
url http://europepmc.org/articles/PMC3765270?pdf=render
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