Comparison of Quantiferon-TB Gold With Tuberculin Skin Test for Detecting Latent Tuberculosis Infection Prior to Liver Transplantation

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Comparison of Quantiferon-TB Gold With Tuberculin Skin Test for Detecting Latent Tuberculosis Infection Prior to Liver Transplantation

Authors: , O.; Humar, A.1; Preiksaitis, J.2; Doucette, K.1; Shokoples, S.2; Peleg, A. Y.; Cobos, I.1; Kumar, D.1

Source: American Journal of Transplantation, Volume 7, Number 12, December 2007 , pp. 2797-2801(5)

Abstract:

Screening for latent tuberculosis infection (LTBI) is recommended prior to organ transplantation. The Quantiferon-TB Gold assay (QFT-G) may be more accurate than the tuberculin skin test (TST) in the detection of LTBI. We prospectively compared the results of QFT-G to TST in patients with chronic liver disease awaiting transplantation. Patients were screened for LTBI with both the QFT-G test and a TST. Concordance between test results and predictors of a discordant result were determined. Of the 153 evaluable patients, 37 (24.2%) had a positive TST and 34 (22.2%) had a positive QFT-G. Overall agreement between tests was 85.1% (κ= 0.60, p < 0.0001). Discordant test results were seen in 12 TST positive/QFT-G negative patients and in 9 TST negative/QFT-G positive patients. Prior BCG vaccination was not associated with discordant test results. Twelve patients (7.8%), all with a negative TST, had an indeterminate result of the QFT-G and this was more likely in patients with a low lymphocyte count (p = 0.01) and a high MELD score (p = 0.001). In patients awaiting liver transplantation, both the TST and QFT-G were comparable for the diagnosis of LTBI with reasonable concordance between tests. Indeterminate QFT-G result was more likely in those with more advanced liver disease.

Keywords: End-stage liver disease; interferon-γ release assay; Mycobacterium tuberculosis; organ transplantation

Document Type: Research article

DOI: 10.1111/j.1600-6143.2007.02011.x

Affiliations: 1: Transplant Infectious Diseases 2: Microbiology, University of Alberta, Edmonton, Alberta, Canada