Correlation between the tuberculin skin test and T‑SPOT.TB in patients with suspected tuberculosis infection: A pilot study

  • Authors:
    • Jing Yang
    • Weiliang Kong
    • Ning Xv
    • Xiaoping Huang
    • Xueqing Chen
  • View Affiliations

  • Published online on: July 18, 2019     https://doi.org/10.3892/etm.2019.7791
  • Pages: 2250-2254
Metrics: Total Views: 0 (Spandidos Publications: | PMC Statistics: )
Total PDF Downloads: 0 (Spandidos Publications: | PMC Statistics: )


Abstract

T‑SPOT.TB is a novel screening method for Mycobacterium tuberculosis infection. However, it is controversial whether T‑SPOT.TB should become an alternative method to the tuberculin skin test (TST) for screening M. tuberculosis infections. The present study aimed to evaluate this issue based on the retrospective analysis of clinical cases. TST and T‑SPOT.TB tests were used on patients with suspected M. tuberculosis infection on admission. Demographic data and clinical information, including previous history of M. tuberculosis infection, were collected. A total of 118 patients were included in the analysis, among whom 30 (25.4%) were diagnosed with active M. tuberculosis infection, and seven patients (5.9%) were currently receiving immunosuppressive treatment. The overall sensitivity and specificity of the TST were 76.7 and 77.3%, respectively, while they were 88.3 and 68.1%, respectively, for the T‑SPOT.TB test. Patients with large TST indurations had a higher number of gamma interferon‑producing T cells among peripheral blood mononuclear cells compared with those of TST‑negative patients. In conclusion, the T‑SPOT.TB test had a higher sensitivity than the TST, but the difference was not statistically significant. Neither the T‑SPOT.TB test nor the TST was sufficiently accurate to detect active M. tuberculosis infection.

References

1 

Organization WH: Global tuberculosis report 2018. simplehttp://www.who.int/tb/publications/global_report/en/December 26–2018

2 

Dinnes J, Deeks J, Kunst H, Gibson A, Cummins E, Waugh N, Drobniewski F and Lalvani A: A systematic review of rapid diagnostic tests for the detection of tuberculosis infection. Health Technol Assess. 11:1–196. 2007. View Article : Google Scholar : PubMed/NCBI

3 

Pai M, Zwerling A and Menzies D: Systematic review: T-cell-based assays for the diagnosis of latent tuberculosis infection: An update. Ann Intern Med. 149:177–184. 2008. View Article : Google Scholar : PubMed/NCBI

4 

Sun L, Xiao J, Miao Q, Feng WX, Wu XR, Yin QQ, Jiao WW, Shen C, Liu F, Shen D and Shen AD: Interferon gamma release assay in diagnosis of pediatric tuberculosis: A meta-analysis-gamma. FEMS Immunol Med Microbiol. 63:165–173. 2011. View Article : Google Scholar : PubMed/NCBI

5 

Sester M, Sotgiu G, Lange C, Giehl C, Girardi E, Migliori GB, Bossink A, Dheda K, Diel R, Dominguez J, et al: Interferon-γ release assays for the diagnosis of active tuberculosis: A systematic review and meta-analysis-γA. Eur Respir J. 37:100–111. 2011. View Article : Google Scholar : PubMed/NCBI

6 

Lu P, Chen X, Zhu LM and Yang HT: Interferon-gamma release assays for the diagnosis of tuberculosis: A systematic review and meta-analysis. Lung. 194:447–458. 2016. View Article : Google Scholar : PubMed/NCBI

7 

Diagnostic standards and classification of tuberculosis in adults and children, . This official statement of the American thoracic society and the centers for disease control and prevention was adopted by the ats board of directors, July 1999. This statement was endorsed by the council of the infectious disease society of America, September 1999. Am J Respir Crit Care Med. 161:1376–1395. 2000. View Article : Google Scholar : PubMed/NCBI

8 

Im JG, Itoh H, Shim YS, Lee JH, Ahn J, Han MC and Noma S: Pulmonary tuberculosis: CT findings-early active disease and sequential change with antituberculous therapy. Radiology. 186:653–660. 1993. View Article : Google Scholar : PubMed/NCBI

9 

Im JG, Webb WR, Han MC and Park JH: Apical opacity associated with pulmonary tuberculosis: High-resolution CT findings. Radiology. 178:727–731. 1991. View Article : Google Scholar : PubMed/NCBI

10 

Liang QL, Shi HZ, Wang K, Qin SM and Qin XJ: Diagnostic accuracy of adenosine deaminase in tuberculous pleurisy: A meta-analysis. Respir Med. 102:744–754. 2008. View Article : Google Scholar : PubMed/NCBI

11 

Pai M, Riley LW and Colford JM Jr: Interferon-gamma assays in the immunodiagnosis of tuberculosis: A systematic review. Lancet Infect Dis. 4:761–776. 2004. View Article : Google Scholar : PubMed/NCBI

12 

Diel R, Loddenkemper R and Nienhaus A: Evidence-based comparison of commercial interferon-gamma release assays for detecting active TB: A metaanalysis. Chest. 137:952–968. 2010. View Article : Google Scholar : PubMed/NCBI

13 

Kang WL, Wang GR, Wu MY, Yang KY, Er-Tai A, Wu SC, Geng SJ, Li ZH, Li MW, Li L and Tang SJ: Interferon-gamma release assay is not appropriate for the diagnosis of active tuberculosis in high-burden tuberculosis settings: A retrospective multicenter investigation. Chin Med J (Engl). 131:268–275. 2018. View Article : Google Scholar : PubMed/NCBI

14 

Pai M and Menzies D: Interferon-gamma release assays: What is their role in the diagnosis of active tuberculosis? Clin Infect Dis. 44:74–77. 2007. View Article : Google Scholar : PubMed/NCBI

15 

Metcalfe JZ, Everett CK, Steingart KR, Cattamanchi A, Huang L, Hopewell PC and Pai M: Interferon-γ release assays for active pulmonary tuberculosis diagnosis in adults in low- and middle-income countriesγ: Systematic review and meta-analysis. J Infect Dis. 204 (Suppl 4):S1120–S1129. 2011. View Article : Google Scholar : PubMed/NCBI

16 

Fan L, Chen Z, Hao XH, Hu ZY and Xiao HP: Interferon-gamma release assays for the diagnosis of extrapulmonary tuberculosis: A systematic review and meta-analysis. FEMS Immunol Med Microbiol. 65:456–466. 2012. View Article : Google Scholar : PubMed/NCBI

17 

Goletti D, Carrara S, Butera O, Amicosante M, Ernst M, Sauzullo I, Vullo V, Cirillo D, Borroni E, Markova R, et al: Accuracy of immunodiagnostic tests for active tuberculosis using single and combined results: A multicenter TBNET-study. PLoS One. 3:e34172008. View Article : Google Scholar : PubMed/NCBI

18 

Dosanjh DP, Hinks TS, Innes JA, Deeks JJ, Pasvol G, Hackforth S, Varia H, Millington KA, Gunatheesan R, Guyot-Revol V and Lalvani A: Improved diagnostic evaluation of suspected tuberculosis. Ann Intern Med. 148:325–336. 2008. View Article : Google Scholar : PubMed/NCBI

19 

Cruz AT and Starke JR: Relationship between tuberculin skin test (TST) size and interferon gamma release assay (IGRA) result: When should clinicians obtain IGRAs in children with positive TSTs? Clin Pediatr (Phila). 53:1196–1199. 2014. View Article : Google Scholar : PubMed/NCBI

20 

Leung CC, Yam WC, Yew WW, Ho PL, Tam CM, Law WS, Wong MY, Leung M and Tsui D: Comparison of T-Spot.TB and tuberculin skin test among silicotic patients. Eur Respir J. 31:266–272. 2008. View Article : Google Scholar : PubMed/NCBI

21 

Mahan CS, Johnson DF, Curley C and van der Kuyp F: Concordance of a positive tuberculin skin test and an interferon gamma release assay in bacille Calmette-Guérin vaccinated persons. Int J Tuberc Lung Dis. 15174–178. (i)2011.PubMed/NCBI

22 

Gualano G, Mencarini P, Lauria FN, Palmieri F, Mfinanga S, Mwaba P, Chakaya J, Zumla A and Ippolito G: Tuberculin skin test-Outdated or still useful for Latent TB infection screening? Int J Infect Dis 80S. S20–S22. 2019. View Article : Google Scholar

23 

Tissot F, Zanetti G, Francioli P, Zellweger JP and Zysset F: Influence of bacille Calmette-Guérin vaccination on size of tuberculin skin test reaction: To what size? Clin Infect Dis. 40:211–217. 2005. View Article : Google Scholar : PubMed/NCBI

24 

Mazurek GH, Lobue PA, Daley CL, Bernardo J, Lardizabal AA, Bishai WR, Iademarco MF and Rothel JS: Comparison of a whole-blood interferon gamma assay with tuberculin skin testing for detecting latent Mycobacterium tuberculosis infection. JAMA. 286:1740–1747. 2001. View Article : Google Scholar : PubMed/NCBI

25 

Mack U, Migliori GB, Sester M, Rieder HL, Ehlers S, Goletti D, Bossink A, Magdorf K, Hölscher C, Kampmann B, et al: LTBI: latent tuberculosis infection or lasting immune responses to M. tuberculosis? A TBNET consensus statement. Eur Respir J. 33:956–973. 2009. View Article : Google Scholar : PubMed/NCBI

26 

Auguste P, Tsertsvadze A, Pink J, Court R, McCarthy N, Sutcliffe P and Clarke A: Comparing interferon-gamma release assays with tuberculin skin test for identifying latent tuberculosis infection that progresses to active tuberculosis: Systematic review and meta-analysis. BMC Infect Dis. 17:2002017. View Article : Google Scholar : PubMed/NCBI

Related Articles

Journal Cover

September 2019
Volume 18 Issue 3

Print ISSN: 1792-0981
Online ISSN:1792-1015

Sign up for eToc alerts

Recommend to Library

Copy and paste a formatted citation
APA
Yang, J., Kong, W., Xv, N., Huang, X., & Chen, X. (2019). Correlation between the tuberculin skin test and T‑SPOT.TB in patients with suspected tuberculosis infection: A pilot study. Experimental and Therapeutic Medicine, 18, 2250-2254. https://doi.org/10.3892/etm.2019.7791
MLA
Yang, J., Kong, W., Xv, N., Huang, X., Chen, X."Correlation between the tuberculin skin test and T‑SPOT.TB in patients with suspected tuberculosis infection: A pilot study". Experimental and Therapeutic Medicine 18.3 (2019): 2250-2254.
Chicago
Yang, J., Kong, W., Xv, N., Huang, X., Chen, X."Correlation between the tuberculin skin test and T‑SPOT.TB in patients with suspected tuberculosis infection: A pilot study". Experimental and Therapeutic Medicine 18, no. 3 (2019): 2250-2254. https://doi.org/10.3892/etm.2019.7791