PURPOSE: Current tools for the diagnosis of tuberculous pleural effusions (TPE) are sub-optimal. New blood based interferon gamma release assay (IGRA) are alternative method for latent tuberculosis diagnosis. Nonetheless, their role in TPE is not yet to be defined. The aim of this study was to evaluate the usefulness QuantiFERON(r) TB Gold In-tube assay (QFT-IT) in the diagnosis of TPE where tuberculosis is endemic and BCG vaccination is mandatory.
METHODS: The tuberculin skin test (TST) and blood QFT-IT tests are conducted prospectively from 101 consecutive patients presenting with clinically suspected TPE at our hospitals in South Korea.
RESULTS: Of 97 evaluable subjects 54 and 43 had TPE and non-TPE, respectively. The respective outcomes [sensitivity, specificity, positive predictive value, negative predictive value %] for the different diagnostic modalities were; QFT-IT [76.9; 61.1; 74.1; 64.7], TST [72.5; 71.7; 77.1; 66.7], QFT-IT plus TST [83.7; 45.7; 68.3; 66.7].
CONCLUSION: QFT-IT test might be a more useful method of diagnosing TPE than TST. The combination with TST improved the sensitivity of QFT-IT.
CLINICAL IMPLICATIONS: Although the higher sensitivity of combination of QFT-IT and TST may be useful in TPE diagnosis, they are limited by their poor specificity due to the high prevalence of latent TB in our settings.
DISCLOSURE: Jae Ho Chung, No Financial Disclosure Information; No Product/Research Disclosure Information