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Clinical Significance of T SPOT.TB Assays in Patients With Suspected Tuberculosis and Healthy Adults FREE TO VIEW

In-Gyu Hyun, PhD; Cheol-Hong Kim, PhD; Ki-Suck Jung, PhD
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Hallym University College of Medicine, Seoul, Republic of Korea



Chest. 2011;140(4_MeetingAbstracts):949A. doi:10.1378/chest.1105421
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Abstract

PURPOSE: Interferon-λ assays (T SPOT.TB, Oxford Immunotec, UK) based on Mycobacterium tuberculosis specific antigens (ESAT-6 and CFP-10) are useful in the diagnosis of tuberculosis (TB) or latent infection. We evaluated the clinical role of T SPOT.TB assays in patients with suspected TB and healthy adults in routine clinical practice, in the area of intermediate TB burden and BCG-vaccinated population. Methods: T SPOT.TB assays were performed in 196 participants prospectively. They were classified with three groups: group I, patients with active TB (n=41); group II, patients without TB (n=93); group III, healthy adults (n=62). The results of T SPOT.TB assays according to clinical characteristics was obtained.

METHODS: T SPOT.TB assays were performed in 196 participants prospectively. They were classified with three groups: group I, patients with active TB (n=41); group II, patients without TB (n=93); group III, healthy adults (n=62). The results of T SPOT.TB assays according to clinical characteristics was obtained.

RESULTS: Positive rates of T SPOT.TB assays in group I, group II and group III were 87.8%, 55.9% and 24.2%, respectively: group I vs. group II, III (P < 0.001, P < 0.001); group II vs. group III (P < 0.0001). The sensitivity and specificity of T SPOT.TB assays from group I and group III were 87.8% and 75.8%. Negative predictive value from group I and II was 89.1%. Average spot counts of group I were higher than those of group II and III (P < 0.05). Agreements between the tuberculin skin test (10-mm cutoff) and T SPOT. TB assays were 66.1% (kappa = 0.335) in all participants and 80.1% (kappa = 0.412) in group I. T SPOT. TB assays were associated with older age, TB history and fibrotic scar on chest X-ray.

CONCLUSIONS: T SPOT TB assays seem to be a useful supplementary diagnosing test of tuberculosis because of its high sensitivity and negative predictive value. Then, the results of T SPOT TB assays should be cautiously interpreted in Korea, where the TB incidence is intermediate.

CLINICAL IMPLICATIONS: T SPOT TB assays seem to be useful for diagnosing tuberculosis in Korea

DISCLOSURE: The following authors have nothing to disclose: In-Gyu Hyun, Cheol-Hong Kim, Ki-Suck Jung

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