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Absence of interferon-gamma release assay conversion following tuberculin skin testing

Absence of interferon-gamma release assay conversion following tuberculin skin testing
Absence of interferon-gamma release assay conversion following tuberculin skin testing
Background: The tuberculin skin test (TST) has been the established screening method for tuberculosis (TB) for over a century. Interferon-gamma release assays (IGRAs) using Mycobacterium tuberculosis-specific antigens are increasingly used as diagnostic tests for TB. Tuberculin comprises multiple antigens, including the antigens used in the QuantiFERON®-TB Gold In-Tube (QFT-GIT) assay. Exposure to these antigens by means of a TST may prime an immune response that leads to a false-positive result in a subsequent IGRA, limiting the validity of IGRAs in patients in whom these tests are performed sequentially. The current data on the influence of prior TST on IGRAs show inconsistent results.

Methods: Sixteen non-bacille Calmette-Guérin immunised medical students with no history of TB exposure and minimal risk of exposure to TB during the study period were tested simultaneously with a TST and QFT-GIT. The QFT-GIT assay was repeated 6 and 10 weeks later.

Results: At baseline, all TST and QFT-GIT results were negative and remained negative 6 and 10 weeks after the TST.

Conclusion: These data show that negative QFT-GIT results are reproducible and suggest that a TST does not result in conversion of subsequent QFT-GIT assays in the absence of concomitant TB exposure. Therefore, a positive QFT-GIT should not be attributed to boosting induced by a previous TST.
boosting, igra, mantoux, quantiferon, ppd
1027-3719
767-769
Ritz, N.
01953c34-5267-4807-8f93-1c6973f7d57c
Yau, C.
dd99c593-a5a0-41b4-b733-5b44174698ae
Connell, T.G.
5535c7a7-38cc-48db-a48e-aaad185b5d3d
Tebruegge, M.
2c3dff22-0b5f-48a7-bb36-ce323705f74a
Leslie, D.
59905221-fcd1-42fc-a76c-90e110ac6c0e
Curtis, N.
f12bb8b9-1dd8-42c3-b0a8-93cb0005d5cb
Ritz, N.
01953c34-5267-4807-8f93-1c6973f7d57c
Yau, C.
dd99c593-a5a0-41b4-b733-5b44174698ae
Connell, T.G.
5535c7a7-38cc-48db-a48e-aaad185b5d3d
Tebruegge, M.
2c3dff22-0b5f-48a7-bb36-ce323705f74a
Leslie, D.
59905221-fcd1-42fc-a76c-90e110ac6c0e
Curtis, N.
f12bb8b9-1dd8-42c3-b0a8-93cb0005d5cb

Ritz, N., Yau, C., Connell, T.G., Tebruegge, M., Leslie, D. and Curtis, N. (2011) Absence of interferon-gamma release assay conversion following tuberculin skin testing. International Journal of Tuberculosis and Lung Disease, 15 (6), 767-769. (doi:10.5588/ijtld.10.0339). (PMID:21575296)

Record type: Article

Abstract

Background: The tuberculin skin test (TST) has been the established screening method for tuberculosis (TB) for over a century. Interferon-gamma release assays (IGRAs) using Mycobacterium tuberculosis-specific antigens are increasingly used as diagnostic tests for TB. Tuberculin comprises multiple antigens, including the antigens used in the QuantiFERON®-TB Gold In-Tube (QFT-GIT) assay. Exposure to these antigens by means of a TST may prime an immune response that leads to a false-positive result in a subsequent IGRA, limiting the validity of IGRAs in patients in whom these tests are performed sequentially. The current data on the influence of prior TST on IGRAs show inconsistent results.

Methods: Sixteen non-bacille Calmette-Guérin immunised medical students with no history of TB exposure and minimal risk of exposure to TB during the study period were tested simultaneously with a TST and QFT-GIT. The QFT-GIT assay was repeated 6 and 10 weeks later.

Results: At baseline, all TST and QFT-GIT results were negative and remained negative 6 and 10 weeks after the TST.

Conclusion: These data show that negative QFT-GIT results are reproducible and suggest that a TST does not result in conversion of subsequent QFT-GIT assays in the absence of concomitant TB exposure. Therefore, a positive QFT-GIT should not be attributed to boosting induced by a previous TST.

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More information

Published date: June 2011
Keywords: boosting, igra, mantoux, quantiferon, ppd
Organisations: Faculty of Medicine

Identifiers

Local EPrints ID: 337611
URI: http://eprints.soton.ac.uk/id/eprint/337611
ISSN: 1027-3719
PURE UUID: 226988a7-4765-444f-92e5-0a2e9b655512

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Date deposited: 01 May 2012 10:33
Last modified: 16 Jul 2019 22:06

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Contributors

Author: N. Ritz
Author: C. Yau
Author: T.G. Connell
Author: M. Tebruegge
Author: D. Leslie
Author: N. Curtis

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