In-hospital blood collection increases the rate of indeterminate results in interferon-gamma release assays

Background: 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 2...

Full description

Bibliographic Details
Main Authors: Yuki Osakabe, Fumihiro Yamaguchi, Ayako Suzuki, Haruka Kitano, Mina Hiraiwa, Yo Shiratori, Shota Onozaki, Mari Nakamoto, Saori Kawamura, Miku Kosuge, Kenji Atarashi, Hidekazu Cho, Shohei Shimizu, Akira Fujishima, Yusuke Shikama
Format: Article
Language:English
Published: SAGE Publishing 2022-02-01
Series:Therapeutic Advances in Respiratory Disease
Online Access:https://doi.org/10.1177/17534666221077817
_version_ 1797853336492310528
author Yuki Osakabe
Fumihiro Yamaguchi
Ayako Suzuki
Haruka Kitano
Mina Hiraiwa
Yo Shiratori
Shota Onozaki
Mari Nakamoto
Saori Kawamura
Miku Kosuge
Kenji Atarashi
Hidekazu Cho
Shohei Shimizu
Akira Fujishima
Yusuke Shikama
author_facet Yuki Osakabe
Fumihiro Yamaguchi
Ayako Suzuki
Haruka Kitano
Mina Hiraiwa
Yo Shiratori
Shota Onozaki
Mari Nakamoto
Saori Kawamura
Miku Kosuge
Kenji Atarashi
Hidekazu Cho
Shohei Shimizu
Akira Fujishima
Yusuke Shikama
author_sort Yuki Osakabe
collection DOAJ
description Background: 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. Objectives: The aim of this study was to investigate the clinical features and predictors of indeterminate results by the QFT-plus test in routine practice. Methods: 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. Results: 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. Conclusion: 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.
first_indexed 2024-04-09T19:47:54Z
format Article
id doaj.art-aa9bedf1a8bd45169582e6ae623652f0
institution Directory Open Access Journal
issn 1753-4666
language English
last_indexed 2024-04-09T19:47:54Z
publishDate 2022-02-01
publisher SAGE Publishing
record_format Article
series Therapeutic Advances in Respiratory Disease
spelling doaj.art-aa9bedf1a8bd45169582e6ae623652f02023-04-03T13:05:13ZengSAGE PublishingTherapeutic Advances in Respiratory Disease1753-46662022-02-011610.1177/17534666221077817In-hospital blood collection increases the rate of indeterminate results in interferon-gamma release assaysYuki OsakabeFumihiro YamaguchiAyako SuzukiHaruka KitanoMina HiraiwaYo ShiratoriShota OnozakiMari NakamotoSaori KawamuraMiku KosugeKenji AtarashiHidekazu ChoShohei ShimizuAkira FujishimaYusuke ShikamaBackground: 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. Objectives: The aim of this study was to investigate the clinical features and predictors of indeterminate results by the QFT-plus test in routine practice. Methods: 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. Results: 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. Conclusion: 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.https://doi.org/10.1177/17534666221077817
spellingShingle Yuki Osakabe
Fumihiro Yamaguchi
Ayako Suzuki
Haruka Kitano
Mina Hiraiwa
Yo Shiratori
Shota Onozaki
Mari Nakamoto
Saori Kawamura
Miku Kosuge
Kenji Atarashi
Hidekazu Cho
Shohei Shimizu
Akira Fujishima
Yusuke Shikama
In-hospital blood collection increases the rate of indeterminate results in interferon-gamma release assays
Therapeutic Advances in Respiratory Disease
title In-hospital blood collection increases the rate of indeterminate results in interferon-gamma release assays
title_full In-hospital blood collection increases the rate of indeterminate results in interferon-gamma release assays
title_fullStr In-hospital blood collection increases the rate of indeterminate results in interferon-gamma release assays
title_full_unstemmed In-hospital blood collection increases the rate of indeterminate results in interferon-gamma release assays
title_short In-hospital blood collection increases the rate of indeterminate results in interferon-gamma release assays
title_sort in hospital blood collection increases the rate of indeterminate results in interferon gamma release assays
url https://doi.org/10.1177/17534666221077817
work_keys_str_mv AT yukiosakabe inhospitalbloodcollectionincreasestherateofindeterminateresultsininterferongammareleaseassays
AT fumihiroyamaguchi inhospitalbloodcollectionincreasestherateofindeterminateresultsininterferongammareleaseassays
AT ayakosuzuki inhospitalbloodcollectionincreasestherateofindeterminateresultsininterferongammareleaseassays
AT harukakitano inhospitalbloodcollectionincreasestherateofindeterminateresultsininterferongammareleaseassays
AT minahiraiwa inhospitalbloodcollectionincreasestherateofindeterminateresultsininterferongammareleaseassays
AT yoshiratori inhospitalbloodcollectionincreasestherateofindeterminateresultsininterferongammareleaseassays
AT shotaonozaki inhospitalbloodcollectionincreasestherateofindeterminateresultsininterferongammareleaseassays
AT marinakamoto inhospitalbloodcollectionincreasestherateofindeterminateresultsininterferongammareleaseassays
AT saorikawamura inhospitalbloodcollectionincreasestherateofindeterminateresultsininterferongammareleaseassays
AT mikukosuge inhospitalbloodcollectionincreasestherateofindeterminateresultsininterferongammareleaseassays
AT kenjiatarashi inhospitalbloodcollectionincreasestherateofindeterminateresultsininterferongammareleaseassays
AT hidekazucho inhospitalbloodcollectionincreasestherateofindeterminateresultsininterferongammareleaseassays
AT shoheishimizu inhospitalbloodcollectionincreasestherateofindeterminateresultsininterferongammareleaseassays
AT akirafujishima inhospitalbloodcollectionincreasestherateofindeterminateresultsininterferongammareleaseassays
AT yusukeshikama inhospitalbloodcollectionincreasestherateofindeterminateresultsininterferongammareleaseassays