Reversions of QuantiFERON-TB Gold Plus in tuberculosis contact investigation: A prospective multicentre cohort study

oleh: Sandra Pérez-Recio, Maria D. Grijota-Camino, Luis Anibarro, Ramón Rabuñal-Rey, Josefina Sabria, Paloma Gijón-Vidaurreta, Virginia Pomar, Mercedes García-Gasalla, Ángel Domínguez-Castellano, Matilde Trigo, María Jesús Santos, Alba Cebollero, Sara Rodríguez, Esther Moga, Anton Penas-Truque, Carmen Martos, M. Jesús Ruiz-Serrano, Erika I. Garcia-de-Cara, Fernando Alcaide, Miguel Santin

Format: Article
Diterbitkan: Public Library of Science (PLoS) 2023-01-01

Deskripsi

<h4>Background</h4> Interferon-y Release Assays (IGRA) reversions have been reported in different clinical scenarios for the diagnosis of tuberculosis (TB) infection. This study aimed to determine the rate of QuantiFERON-TB Gold Plus (QFT-Plus) reversions during contact investigation as a potential strategy to reduce the number of preventive treatments. <h4>Methods</h4> Prospective, multicentre cohort study of immunocompetent adult contacts of patients with pulmonary TB tested with QFT-Plus. Contacts with an initial positive QFT-Plus (QFT-i) underwent a second test within 4 weeks (QFT-1), and if negative, underwent a repeat test 4 weeks later (QFT-2). Based on the QFT-2 result, we classified cases as sustained reversion if they remained negative and as temporary reversion if they turned positive. <h4>Results</h4> We included 415 contacts, of whom 96 (23.1%) had an initial positive test (QFT-i). Following this, 10 had negative QFT-1 results and 4 (4.2%) of these persisted with a negative result in the QFT-2 (sustained reversions). All four sustained reversions occurred in contacts with IFN-γ concentrations between ≥0.35 and ≤0.99 IU•mL-1 in one or both QFT-i tubes. <h4>Conclusion</h4> In this study, TB contact investigations rarely reveal QFT-Plus reversion. These results do not support retesting cases with an initial positive result to reduce the number of preventive treatments.