Kinetics of the QuantiFERON^®-TB Gold In-Tube test during treatment of patients with sputum smear-positive tuberculosis in relation to initial TST result and severity of disease

Abstract

The QuantiFERON^®-TB Gold In-Tube test (QFN) measures interferon-gamma production in response to Mycobacterium tuberculosis antigens. Our aim was to assess the kinetics of the QFN and initial tuberculin skin test (TST) result in relation to severity of disease in a tuberculosis (TB) endemic area. Smear-positive TB patients (n = 71) were recruited at Gondar University Hospital, Ethiopia. The TST, QFN, CD4+ cell count and clinical symptoms (TB score) were assessed and followed up during treatment. From baseline to 7 months after treatment, there was a significant decrease in QFN reactivity (93.8% to 62.5% in HIV-negative/TB; 70.3% to 33.3% in HIV-positive/TB patients) down to a level comparable to a control group of blood donors (51.2%). The agreement between TST and QFN was poor in TB patients compared to healthy controls. A negative TST correlated to more advanced TB in contrast to a negative QFN test. We conclude that the QFN reactivity is significantly reduced at the end of treatment against active TB to the background level of healthy blood donors, and that the agreement between TST and QFN is poor including correlation to the severity of disease.

Acknowledgements

The authors wish to thank Nurse Meseret Senbeto, Mr Tezera Jemere, Ms Saba Ekubay, Mr Belay Anagaw for invaluable support in monitoring patients and handling patient samples. We also wish to thank the study participants without whom the study would not have been possible. Financial support was received from the Swedish Heart and Lung Foundation, SAREC/SIDA and the Swedish Research Council.

Declaration of interest: No conflict of interest to declare.