Association of Mycobacterium tuberculosis infection test results with risk factors for tuberculosis transmission
Background: Close contacts infected with Mycobacterium tuberculosis are at high risk of tuberculosis (TB) disease and a priority for preventive treatment. Three tests measure infection: two interferon-gamma release assays (IGRAs) and the tuberculin skin test (TST). The objective of our study was to...
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| Format: | Article |
| Language: | English |
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Elsevier
2023-12-01
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| Series: | Journal of Clinical Tuberculosis and Other Mycobacterial Diseases |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2405579423000426 |
| _version_ | 1827620743629766656 |
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| author | Thara Venkatappa Dan Shen Aurimar Ayala Rongxia Li Yoseph Sorri Rose Punnoose Dolly Katz |
| author_facet | Thara Venkatappa Dan Shen Aurimar Ayala Rongxia Li Yoseph Sorri Rose Punnoose Dolly Katz |
| author_sort | Thara Venkatappa |
| collection | DOAJ |
| description | Background: Close contacts infected with Mycobacterium tuberculosis are at high risk of tuberculosis (TB) disease and a priority for preventive treatment. Three tests measure infection: two interferon-gamma release assays (IGRAs) and the tuberculin skin test (TST). The objective of our study was to assess the association of positive test results in contacts with infectiousness of the presumed TB source case. Methods: Contacts in a cohort study at 10 United States sites received both IGRAs (QuantiFERON-TB Gold In-Tube (QFT-GIT) and T-SPOT.TB (T-SPOT)) and TST. We defined test conversion as negative for all tests at baseline and positive for at least one on retest. Risk ratios (RR) and 95% confidence intervals (CI) assessed association of positive test results with increased infectiousness of the TB case—defined as acid-fast bacilli (AFB) on sputum microscopy or cavities on chest radiographs— and contact demographics. Results: Adjusted for contacts’ age, nativity, sex, and race, IGRAs (QFT-GIT RR = 6.1, 95% CI 1.7–22.2; T-SPOT RR = 9.4, 95% CI 1.1–79.1), but not TST (RR = 1.7, 95% CI 0.8–3.7), were more likely to convert among contacts exposed to persons with cavitary TB disease. Conclusions: Because IGRA conversions in contacts are associated with infectiousness of the TB case, their use may improve efficiency of health department contact investigations by focusing efforts on those likely to benefit from preventive treatment in the United States. |
| first_indexed | 2024-03-09T10:52:17Z |
| format | Article |
| id | doaj.art-4da93420658a406a966217fc4a66d8b2 |
| institution | Directory Open Access Journal |
| issn | 2405-5794 |
| language | English |
| last_indexed | 2024-03-09T10:52:17Z |
| publishDate | 2023-12-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Journal of Clinical Tuberculosis and Other Mycobacterial Diseases |
| spelling | doaj.art-4da93420658a406a966217fc4a66d8b22023-12-01T05:02:18ZengElsevierJournal of Clinical Tuberculosis and Other Mycobacterial Diseases2405-57942023-12-0133100386Association of Mycobacterium tuberculosis infection test results with risk factors for tuberculosis transmissionThara Venkatappa0Dan Shen1Aurimar Ayala2Rongxia Li3Yoseph Sorri4Rose Punnoose5Dolly Katz6Division of Tuberculosis Elimination, Centers for Disease Control and Prevention, Atlanta, GA, USA; Corresponding author.Maricopa County Department of Public Health, 1645 E Roosevelt St, Phoenix, AZ 85006, USAMaricopa County Department of Public Health, 1645 E Roosevelt St, Phoenix, AZ 85006, USADivision of Tuberculosis Elimination, Centers for Disease Control and Prevention, Atlanta, GA, USASeattle-King County Public Health TB Clinic, 325 9th Ave HMC Box 359776, Seattle, WA 98104, USAPeraton, Atlanta, 2800 Century Parkway, NE, GA 30345, USADivision of Tuberculosis Elimination, Centers for Disease Control and Prevention, Atlanta, GA, USABackground: Close contacts infected with Mycobacterium tuberculosis are at high risk of tuberculosis (TB) disease and a priority for preventive treatment. Three tests measure infection: two interferon-gamma release assays (IGRAs) and the tuberculin skin test (TST). The objective of our study was to assess the association of positive test results in contacts with infectiousness of the presumed TB source case. Methods: Contacts in a cohort study at 10 United States sites received both IGRAs (QuantiFERON-TB Gold In-Tube (QFT-GIT) and T-SPOT.TB (T-SPOT)) and TST. We defined test conversion as negative for all tests at baseline and positive for at least one on retest. Risk ratios (RR) and 95% confidence intervals (CI) assessed association of positive test results with increased infectiousness of the TB case—defined as acid-fast bacilli (AFB) on sputum microscopy or cavities on chest radiographs— and contact demographics. Results: Adjusted for contacts’ age, nativity, sex, and race, IGRAs (QFT-GIT RR = 6.1, 95% CI 1.7–22.2; T-SPOT RR = 9.4, 95% CI 1.1–79.1), but not TST (RR = 1.7, 95% CI 0.8–3.7), were more likely to convert among contacts exposed to persons with cavitary TB disease. Conclusions: Because IGRA conversions in contacts are associated with infectiousness of the TB case, their use may improve efficiency of health department contact investigations by focusing efforts on those likely to benefit from preventive treatment in the United States.http://www.sciencedirect.com/science/article/pii/S2405579423000426Tuberculin skin testQuantiFERON-TB Gold In-tubeT-SPOT.TBClose contacts |
| spellingShingle | Thara Venkatappa Dan Shen Aurimar Ayala Rongxia Li Yoseph Sorri Rose Punnoose Dolly Katz Association of Mycobacterium tuberculosis infection test results with risk factors for tuberculosis transmission Journal of Clinical Tuberculosis and Other Mycobacterial Diseases Tuberculin skin test QuantiFERON-TB Gold In-tube T-SPOT.TB Close contacts |
| title | Association of Mycobacterium tuberculosis infection test results with risk factors for tuberculosis transmission |
| title_full | Association of Mycobacterium tuberculosis infection test results with risk factors for tuberculosis transmission |
| title_fullStr | Association of Mycobacterium tuberculosis infection test results with risk factors for tuberculosis transmission |
| title_full_unstemmed | Association of Mycobacterium tuberculosis infection test results with risk factors for tuberculosis transmission |
| title_short | Association of Mycobacterium tuberculosis infection test results with risk factors for tuberculosis transmission |
| title_sort | association of mycobacterium tuberculosis infection test results with risk factors for tuberculosis transmission |
| topic | Tuberculin skin test QuantiFERON-TB Gold In-tube T-SPOT.TB Close contacts |
| url | http://www.sciencedirect.com/science/article/pii/S2405579423000426 |
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