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Role of confirmatory interferon-gamma release assays in school outbreaks of tuberculosis in South Korea

Authors
Kim, H. J.Lee, G-HRyoo, S.Oh, S-Y.Lee, J-B.Kim, J. H.Shin, C.Lee, S. H.
Issue Date
5월-2015
Publisher
INT UNION AGAINST TUBERCULOSIS LUNG DISEASE (I U A T L D)
Keywords
latent tuberculous infection; QuantiFERON test; tuberculin skin test; TB outbreaks
Citation
INTERNATIONAL JOURNAL OF TUBERCULOSIS AND LUNG DISEASE, v.19, no.5, pp.576 - 581
Indexed
SCIE
SCOPUS
Journal Title
INTERNATIONAL JOURNAL OF TUBERCULOSIS AND LUNG DISEASE
Volume
19
Number
5
Start Page
576
End Page
581
URI
https://scholar.korea.ac.kr/handle/2021.sw.korea/93702
DOI
10.5588/ijtld.14.0636
ISSN
1027-3719
Abstract
OBJECTIVE: To investigate the usefulness of confirmatory QuantiFERON (R) (QFT) testing among tuberculin skin test (TST) positive contacts to diagnose latent tuberculous infection (LTBI) in tuberculosis (TB) outbreaks among adolescents. DESIGN: We used the Korean national claims database to identify the development of active TB disease in relation to initial TST (cut-off 10 mm induration) and subsequent QFT results. RESULTS: A total of 7475 contacts in 89 schools were divided into four groups: TST (n=5714), TST+/QFT+ (n = 534), TST+/QFT (n = 697) and TST+ only (n = 530). The mean duration of follow-up was 3.9 +/- 0.9 years. For contacts with no LTBI treatment (n = 6868), TB incidence rates per 1000 person-years (py) and the adjusted hazard ratio (HR) compared with TST-individuals were as follows: TST+/QFT+, 66.2/1000 py (HR 35.59, 95%CI 14.03-90.31, P < 0.001); TST+ only, 10.1/1000 py (HR 5.16, 95%CI 2.91-9.17, P < 0.001); TST+/QFT, 4.0/1000 py (HR 2.05, 95%CI 1.05-4.01, P= 0.035); and TST - 2.0/1000 py. The TB progression rate was significantly higher in TST+/QFT+ than in TST+/QFT individuals (HR 16.82, 95 CI 5.84-48.46, P < 0.001). CONCLUSION: A confirmatory QFT for TST+ contacts could reduce the number of candidates for LTBI treatment after school TB outbreaks. KEY WORDS: latent tuberculous
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