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Role of the quantiferon-TB test in ruling out pleural tuberculosis: a multi-centre study

Role of the quantiferon-TB test in ruling out pleural tuberculosis: a multi-centre study
Role of the quantiferon-TB test in ruling out pleural tuberculosis: a multi-centre study
Diagnosing pleural tuberculosis (plTB) might be difficult due to limited sensitivity of conventional microbiology tools. As M. tuberculosis (MTB)-specific T cells are recruited into pleural space in plTB, their detection may provide useful clinical information. To this aim, in addition to standard diagnostic tests, we used the QuantiFERON-TB Gold In-Tube (QFT-IT) test in blood and pleural effusion (PE) samples from 48 patients with clinical suspicion of plTB, 18 (37.5%) of whom had confirmed plTB. Four of them (22.2%) tested positive with a nucleic acid amplification test for MTB. The tuberculin skin test was positive in most confirmed plTB cases (88.9%). Positive QFT-IT tests were significantly more frequent in patients with confirmed plTB, as compared to patients with an alternative diagnosis, both in blood (77.7 vs 36.6%, p=0.006) and in PE samples (83.3% vs 46.6%, p=0.02). In addition, both blood and PE MTB-stimulated IFN-gamma levels were significantly higher in plTB patients (p=0.03 and p=0.0049 vs non-plTB, respectively). In blood samples, QFT-IT had 77.8% sensitivity and 63.3% specificity, resulting in 56.0% positive (PPV) and 82.6% negative (NPV) predictive values. On PE, QFT-IT sensitivity was 83.3% and specificity 53.3% (PPV 51.7% and NPV 84.2%). The optimal AUC-derived cut-off for MTB-stimulated pleural IFN-gamma level was 3.01 IU/mL (77.8% sensitivity, 80% specificity, PPV 68.4% and NPV 82.8%). These data suggest that QFT-IT might have a role in ruling out plTB in clinical practice.
0394-6320
159-165
Losi, M.
5d48476e-5760-47eb-bd74-573132186a06
Bocchino, M.
af03f31d-631f-4c60-9b58-b4a23eca5bc2
Matarese, A.
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Bellofiore, B.
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Roversi, P.
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Rumpianesi, F.
ff04419f-0660-4845-bd4c-bf81fc66d760
Alma, M.G.
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Chiaradonna, P.
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Del Giovane, C.
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Altieri, A.M.
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Richeldi, L.
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Sanduzzi, A.
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Losi, M.
5d48476e-5760-47eb-bd74-573132186a06
Bocchino, M.
af03f31d-631f-4c60-9b58-b4a23eca5bc2
Matarese, A.
02943ffd-9f7f-4e77-9504-8cd23f6755ec
Bellofiore, B.
0dfdf0d5-29f2-43e0-b61d-790c06478678
Roversi, P.
5645a826-2059-4add-b0f4-c1f761fe2e11
Rumpianesi, F.
ff04419f-0660-4845-bd4c-bf81fc66d760
Alma, M.G.
6086fba1-58d3-4e7e-8b0f-caba6e20b727
Chiaradonna, P.
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Del Giovane, C.
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Altieri, A.M.
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Richeldi, L.
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Sanduzzi, A.
08b86df0-cc75-4cf8-b472-ba7b778d3702

Losi, M., Bocchino, M., Matarese, A., Bellofiore, B., Roversi, P., Rumpianesi, F., Alma, M.G., Chiaradonna, P., Del Giovane, C., Altieri, A.M., Richeldi, L. and Sanduzzi, A. (2011) Role of the quantiferon-TB test in ruling out pleural tuberculosis: a multi-centre study. International Journal of Immunopathology and Pharmacology, 24 (1), 159-165. (PMID:21496398)

Record type: Article

Abstract

Diagnosing pleural tuberculosis (plTB) might be difficult due to limited sensitivity of conventional microbiology tools. As M. tuberculosis (MTB)-specific T cells are recruited into pleural space in plTB, their detection may provide useful clinical information. To this aim, in addition to standard diagnostic tests, we used the QuantiFERON-TB Gold In-Tube (QFT-IT) test in blood and pleural effusion (PE) samples from 48 patients with clinical suspicion of plTB, 18 (37.5%) of whom had confirmed plTB. Four of them (22.2%) tested positive with a nucleic acid amplification test for MTB. The tuberculin skin test was positive in most confirmed plTB cases (88.9%). Positive QFT-IT tests were significantly more frequent in patients with confirmed plTB, as compared to patients with an alternative diagnosis, both in blood (77.7 vs 36.6%, p=0.006) and in PE samples (83.3% vs 46.6%, p=0.02). In addition, both blood and PE MTB-stimulated IFN-gamma levels were significantly higher in plTB patients (p=0.03 and p=0.0049 vs non-plTB, respectively). In blood samples, QFT-IT had 77.8% sensitivity and 63.3% specificity, resulting in 56.0% positive (PPV) and 82.6% negative (NPV) predictive values. On PE, QFT-IT sensitivity was 83.3% and specificity 53.3% (PPV 51.7% and NPV 84.2%). The optimal AUC-derived cut-off for MTB-stimulated pleural IFN-gamma level was 3.01 IU/mL (77.8% sensitivity, 80% specificity, PPV 68.4% and NPV 82.8%). These data suggest that QFT-IT might have a role in ruling out plTB in clinical practice.

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Published date: January 2011
Organisations: Clinical & Experimental Sciences

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Local EPrints ID: 369033
URI: http://eprints.soton.ac.uk/id/eprint/369033
ISSN: 0394-6320
PURE UUID: 7ee4ea47-b85b-4b96-814f-102a40348c9c

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Date deposited: 23 Sep 2014 12:29
Last modified: 22 Jul 2022 19:08

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Contributors

Author: M. Losi
Author: M. Bocchino
Author: A. Matarese
Author: B. Bellofiore
Author: P. Roversi
Author: F. Rumpianesi
Author: M.G. Alma
Author: P. Chiaradonna
Author: C. Del Giovane
Author: A.M. Altieri
Author: L. Richeldi
Author: A. Sanduzzi

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