Screening of tuberculosis infection in household contacts by interferon γ release assay and tuberculin skin test to predict active tuberculosis in China
RUAN Qiao-Ling1, SHAO Ling-Yun1, WU Jing1, ZHANG Shu1, YU Sheng-Lei1, WANG Sen1, GAO Yan1, WANG Fei1, ZHANG Xi-Yan2, LIU Yuan-Yuan1, RAO Ying2, SHEN Yao-Jie1, ZHANG Ying1, ZHANG Wen-Hong1
1. Department of Infectious Diseases，Huashan Hospital，Fudan Universtiy，Shanghai 200040，China; 2.Chongqing Pulmonary Hospital, Chongqing 400020
The purpose of the present study is to investigate the performance of interferon γ release assay (IGRA) and tuberculin skin test (TST) in household contacts of tuberculosis patients, and to evaluate the predictive values of the two tests for disease progression from latent tuberculosis infection (LTBI) to active tuberculosis in China. Household contacts of active pulmonary tuberculosis patients were offered both IGRA (TSPOT.TB) and TST, and then followed up for 6 years. The final cohort comprised 121 household contacts. TSPOT.TB was positive in 49.6% of the contacts; the positive rate was associated with increasing age ﹝OR＝1.03 (95% CI 1.001.05)，P＝0.032﹞and contacting with smearpositive patients ﹝OR＝2.13(95% CI 1.014.51)，P＝0.048﹞. TST≥5 mm and TST≥10 mm accounted for 57.5% and 37.2% of the contacts, respectively. TST≥10 mm was positively associated with contacting with smearpositive patients ﹝OR＝2.30(95% CI 1.055.06)，P＝0.038﹞. Seven cases progressed to tuberculosis within 626 personyears of followup, showing an overall incidence rate of 11.0 per 1 000 personyears. The positive predictive value (PPV) and negative predictive value (NPV) was 8.3% and 96.7% for TSPOT.TB. The PPVs for TST≥5 mm and TST≥10 mm were 7.7% and 9.5% respectively; NPVs were both 95.8%. In conclusion, there is a high incidence rate of active tuberculosis among household contacts compared to general population in China. The predictive values of IGRA and TST for progression to active tuberculosis among household contacts are comparable.
阮巧玲1，邵凌云1，吴晶1，张舒1，虞胜镭1，王森1，高岩1，王菲1，张西雁2，刘袁媛1，饶英2，沈瑶杰1，张颖1，张文宏1. γ干扰素释放试验与结核菌素皮肤试验筛查预测活动性结核病的比较[J]. 微生物与感染, 2015, 10(1): 28-33.
RUAN Qiao-Ling1, SHAO Ling-Yun1, WU Jing1, ZHANG Shu1, YU Sheng-Lei1, WANG Sen1, GAO Yan1, WANG Fei1, ZHANG Xi-Yan2, LIU Yuan-Yuan1, RAO Ying2, SHEN Yao-Jie1, ZHANG Ying1, ZHANG Wen-Hong1. Screening of tuberculosis infection in household contacts by interferon γ release assay and tuberculin skin test to predict active tuberculosis in China. JOURNAL OF MICROBES AND INFECTIONS, 2015, 10(1): 28-33.
