Article: T-spot.TB outperforms tuberculin skin test in predicting tuberculosis disease
| Title | T-spot.TB outperforms tuberculin skin test in predicting tuberculosis disease | ||||||
|---|---|---|---|---|---|---|---|
| Authors | Leung, CC2 Yam, WC1 Yew, WW3 Ho, PL1 Tam, CM2 Law, WS2 Au, KF2 Tsui, PW2 | ||||||
| Keywords | Ifn-Γ Release Assay Latent Tuberculosis Infection Silicosis | ||||||
| Issue Date | 2010 | ||||||
| Publisher | American Thoracic Society. The Journal's web site is located at http://ajrccm.atsjournals.org | ||||||
| Citation | American Journal Of Respiratory And Critical Care Medicine, 2010, v. 182 n. 6, p. 834-840 [How to Cite?] DOI: http://dx.doi.org/10.1164/rccm.200912-1875OC | ||||||
| Abstract | Rationale: Silicosis is a well-recognized risk factor for tuberculosis (TB). Objectives: To compare T-Spot.TB with tuberculin skin test (TST) in predicting the development of TB. Methods:Male patients with silicosis without clinical suspicion of active TB, past history of TB, and treatment for latent TB infection (LTBI) were offered both T-Spot. TB and TST in the Pneumoconiosis Clinic of Hong Kong from 2004 to 2008, and followed prospectively until September 30, 2009, for development of TB. Measurements and Main Results: Active TB and culture- or histology-confirmed TB developed in 17 (5.5%) and 14 (4.5%) of 308 recruited subjects at an annual rate of 2,247 and 1,851 per 100,000 person-years, respectively. Active TB occurred in 7.4% (15 of 204) and 1.9% (2 of 104) of T-Spot. TB-positive and-negative subjects, respectively, whereas the corresponding figures for TST (cutoff 10 mm) were 6.4% (13 of 203) and 3.9% (4 of 205), respectively. Apositive T-Spot. TB test significantly predicted the subsequent development of active TB (relative risk, 4.50; 95% confidence interval, 1.03-19.68) and culture- or histology-confirmed TB (relative risk, 7.80; 95% confidence interval, 1.02-59.63). Consistent results were obtained after exclusion of subjects treated for LTBI and adjustment for potential confounders. TST did not significantly predict the development of active TB or culture- or histology-confirmed TB, irrespective of the cutoff values with or without exclusion of subjects treated for LTBI. Culture filtrate protein 10 spot count, but not early secretary antigenic target 6 spot count, was significantly associated with subsequent TB development. Conclusions: T-Spot. TB performs better than TST in the targeted screening of LTBI among patients with silicosis. | ||||||
| ISSN | 1073-449X 2011 Impact Factor: 11.08 2011 SCImago Journal Rankings: 1.008 | ||||||
| DOI | http://dx.doi.org/10.1164/rccm.200912-1875OC | ||||||
| ISI Accession Number ID | WOS:000282162100017
Funding Information: Supported by research grants from the Pneumoconiosis Compensation Fund Board and from the University of Hong Kong UDF Project-Research Centre of Emerging Infection Diseases. | ||||||
| References | References in Scopus |
| dc.contributor.author | Leung, CC | ||||||
|---|---|---|---|---|---|---|---|
| dc.contributor.author | Yam, WC | ||||||
| dc.contributor.author | Yew, WW | ||||||
| dc.contributor.author | Ho, PL | ||||||
| dc.contributor.author | Tam, CM | ||||||
| dc.contributor.author | Law, WS | ||||||
| dc.contributor.author | Au, KF | ||||||
| dc.contributor.author | Tsui, PW | ||||||
| dc.date.accessioned | 2012-08-08T08:51:38Z | ||||||
| dc.date.available | 2012-08-08T08:51:38Z | ||||||
| dc.date.issued | 2010 | ||||||
| dc.description.abstract | Rationale: Silicosis is a well-recognized risk factor for tuberculosis (TB). Objectives: To compare T-Spot.TB with tuberculin skin test (TST) in predicting the development of TB. Methods:Male patients with silicosis without clinical suspicion of active TB, past history of TB, and treatment for latent TB infection (LTBI) were offered both T-Spot. TB and TST in the Pneumoconiosis Clinic of Hong Kong from 2004 to 2008, and followed prospectively until September 30, 2009, for development of TB. Measurements and Main Results: Active TB and culture- or histology-confirmed TB developed in 17 (5.5%) and 14 (4.5%) of 308 recruited subjects at an annual rate of 2,247 and 1,851 per 100,000 person-years, respectively. Active TB occurred in 7.4% (15 of 204) and 1.9% (2 of 104) of T-Spot. TB-positive and-negative subjects, respectively, whereas the corresponding figures for TST (cutoff 10 mm) were 6.4% (13 of 203) and 3.9% (4 of 205), respectively. Apositive T-Spot. TB test significantly predicted the subsequent development of active TB (relative risk, 4.50; 95% confidence interval, 1.03-19.68) and culture- or histology-confirmed TB (relative risk, 7.80; 95% confidence interval, 1.02-59.63). Consistent results were obtained after exclusion of subjects treated for LTBI and adjustment for potential confounders. TST did not significantly predict the development of active TB or culture- or histology-confirmed TB, irrespective of the cutoff values with or without exclusion of subjects treated for LTBI. Culture filtrate protein 10 spot count, but not early secretary antigenic target 6 spot count, was significantly associated with subsequent TB development. Conclusions: T-Spot. TB performs better than TST in the targeted screening of LTBI among patients with silicosis. | ||||||
| dc.description.nature | Link_to_subscribed_fulltext | ||||||
| dc.identifier.citation | American Journal Of Respiratory And Critical Care Medicine, 2010, v. 182 n. 6, p. 834-840 [How to Cite?] DOI: http://dx.doi.org/10.1164/rccm.200912-1875OC | ||||||
| dc.identifier.doi | http://dx.doi.org/10.1164/rccm.200912-1875OC | ||||||
| dc.identifier.epage | 840 | ||||||
| dc.identifier.hkuros | 179786 | ||||||
| dc.identifier.isi | WOS:000282162100017
Funding Information: Supported by research grants from the Pneumoconiosis Compensation Fund Board and from the University of Hong Kong UDF Project-Research Centre of Emerging Infection Diseases. | ||||||
| dc.identifier.issn | 1073-449X 2011 Impact Factor: 11.08 2011 SCImago Journal Rankings: 1.008 | ||||||
| dc.identifier.issue | 6 | ||||||
| dc.identifier.scopus | eid_2-s2.0-77957069528 | ||||||
| dc.identifier.spage | 834 | ||||||
| dc.identifier.uri | http://hdl.handle.net/10722/157605 | ||||||
| dc.identifier.volume | 182 | ||||||
| dc.language | eng | ||||||
| dc.publisher | American Thoracic Society. The Journal's web site is located at http://ajrccm.atsjournals.org | ||||||
| dc.publisher.place | United States | ||||||
| dc.relation.ispartof | American Journal of Respiratory and Critical Care Medicine | ||||||
| dc.relation.references | References in Scopus | ||||||
| dc.subject | Ifn-Γ Release Assay | ||||||
| dc.subject | Latent Tuberculosis Infection | ||||||
| dc.subject | Silicosis | ||||||
| dc.title | T-spot.TB outperforms tuberculin skin test in predicting tuberculosis disease | ||||||
| dc.type | Article |
Author Affiliations
- The University of Hong Kong
- Centre for Health Protection
- Grantham Hospital Hong Kong