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Tuberculin skin test and interferon‐γ release assays: Can they agree?

2022-12-16Journal article Restricted access
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dc.contributor.authorSantos, João Almeida
dc.contributor.authorDuarte, Raquel
dc.contributor.authorNunes, Carla
dc.date.accessioned2023-03-20T15:05:26Z
dc.date.available2023-03-20T15:05:26Z
dc.date.issued2022-12-16
dc.descriptionFree PMC article: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9892696/pt_PT
dc.description.abstractIntroduction: The diagnosis of latent tuberculosis infection (LTBI) relies largely on the tuberculin skin test (TST) or, more recently, on interferon-gamma release assays (IGRA). Knowledge regarding these tests is essential to improve their usefulness in combating the tuberculosis epidemic. Objectives: To characterize the agreement between the IGRA and TST tests by determining the kappa coefficient (K) and agreement rate between these two tests in patients with active tuberculosis (TB). Methods: Retrospective cohort study conducted with data from active TB patients notified in the Portuguese Tuberculosis Surveillance System (SVIG-TB), from 2008 to 2015. TST results were interpreted using a 5 mm (TST-5 mm) and 10 mm (TST-10 mm) cutoff. Kappa coefficient and agreement rate were calculated in order to evaluate the agreement between IGRA and TST (both cutoffs) test results. Results: A total of 727 patients with results for both tests were included in the study, of which 3.4% (n = 25) had HIV infection, 5.6% (n = 41) diabetes, 5.0% (n = 36) oncological diseases and 4.4% (n = 32) inflammatory diseases. Of the 727 patients, 16.5% (n = 120) presented different outcomes between IGRA and TST-5 mm, and 20.5% (n = 149) presented different outcomes between IGRA and TST-10 mm. Kappa coefficient between IGRA and TST-5 mm was 0.402 (p < 0.001) with an agreement rate of 83.5%. Between IGRA and TST-10 mm, the kappa coefficient was 0.351 (p < 0.001), with an agreement rate of 79.5%. Patients with HIV infection, diabetes, oncologic diseases and inflammatory diseases presented a substantial agreement between IGRA and TST-5 mm, while inflammatory diseases was the only variable that presented a substantial agreement between IGRA and TST-10 mm. Conclusion: As both tests can present false-negative results, the low level of agreement between the tests can potentially help identify more cases of LTBI if the two tests are used in parallel, with infections not detected by IGRA possibly being detected by the TST and vice versa.pt_PT
dc.description.sponsorshipFundação para a Ciência e Tecnologia, Grant/Award Number: PTDC/SAU-PUB/31346/2017pt_PT
dc.description.versioninfo:eu-repo/semantics/publishedVersionpt_PT
dc.identifier.citationClin Respir J. 2023 Feb;17(2):109-114. doi: 10.1111/crj.13569. Epub 2022 Dec 16pt_PT
dc.identifier.doi10.1111/crj.13569pt_PT
dc.identifier.issn1752-699X
dc.identifier.urihttp://hdl.handle.net/10400.18/8576
dc.language.isoengpt_PT
dc.peerreviewedyespt_PT
dc.publisherWiley Open Accesspt_PT
dc.relationFrom symptoms to diagnosis of Urban Tuberculosis, considering individual and contextual factors. What are the determinants and critical points of this delay?s pathway?
dc.relation.publisherversionhttps://onlinelibrary.wiley.com/doi/10.1111/crj.13569pt_PT
dc.rights.urihttp://creativecommons.org/licenses/by/4.0/pt_PT
dc.subjectInterferon-gamma Release Testspt_PT
dc.subjectLatent Tuberculosis Infectionpt_PT
dc.subjectPublic Healthpt_PT
dc.subjectTuberculin Skin Testpt_PT
dc.subjectTuberculosispt_PT
dc.subjectInfecções Respiratóriaspt_PT
dc.titleTuberculin skin test and interferon‐γ release assays: Can they agree?pt_PT
dc.typejournal article
dspace.entity.typePublication
oaire.awardTitleFrom symptoms to diagnosis of Urban Tuberculosis, considering individual and contextual factors. What are the determinants and critical points of this delay?s pathway?
oaire.awardURIinfo:eu-repo/grantAgreement/FCT/3599-PPCDT/PTDC%2FSAU-PUB%2F31346%2F2017/PT
oaire.citation.endPage114pt_PT
oaire.citation.issue2pt_PT
oaire.citation.startPage109pt_PT
oaire.citation.titleThe Clinical Respiratory Journalpt_PT
oaire.citation.volume17pt_PT
oaire.fundingStream3599-PPCDT
project.funder.identifierhttp://doi.org/10.13039/501100001871
project.funder.nameFundação para a Ciência e a Tecnologia
rcaap.embargofctAcesso de acordo com política editorial da revista.pt_PT
rcaap.rightsembargoedAccesspt_PT
rcaap.typearticlept_PT
relation.isProjectOfPublication49a7f05c-5c12-4512-b8a6-5771454c143d
relation.isProjectOfPublication.latestForDiscovery49a7f05c-5c12-4512-b8a6-5771454c143d

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