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Original Research |

Performance of Confirmatory Interferon-γ Release Assays in School TB OutbreaksConfirmatory Interferon-03B3 Release Assays

Seunghwan Song, MD; Doosoo Jeon, MD; Jong Won Kim, MD; Yeong Dae Kim, MD; Sang-Pil Kim, MD; Jeong Su Cho, MD; Seung Eun Lee, MD; Woo Hyun Cho, MD; Hye-Kyung Park, MD; Yun Seong Kim, MD; Min Ki Lee, MD; Jun Ho Lee, MD
Author and Funding Information

From the Department of Thoracic and Cardiovascular Surgery (Drs Song, J. W. Kim, Y. D. Kim, S.-P. Kim, and J. S. Cho,), and the Department of Internal Medicine (Drs Jeon, S. E. Lee, W. H. Cho, Park, Y. S. Kim, and M. K. Lee), School of Medicine, Pusan National University, Busan, Korea; and the Department of Emergency Medicine (Dr J. H. Lee), Samsung Changwon Hospital, Changwon, South Korea.

Correspondence to: Yun Seong Kim, MD, Department of Internal Medicine, School of Medicine, Pusan National University, Pusan National University Yangsan Hospital, Beomeo-ri, Yangsan-si, Gyeongsangnam-do, 626-770, South Korea; e-mail: yskimdr@yahoo.co.kr.


Funding/Support: This study was supported by the Medical Research Institute of Pusan National University [Grant 2005-53].

Drs Song and Jeon contributed equally to this article.

Reproduction of this article is prohibited without written permission from the American College of Chest Physicians (http://www.chestpubs.org/site/misc/reprints.xhtml).


© 2012 American College of Chest Physicians


Chest. 2012;141(4):983-988. doi:10.1378/chest.11-1158
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Background:  Interferon-γ release assays (IGRAs) have been incorporated into several national guidelines for latent TB infection (LTBI) diagnosis. However, their optimal application is still controversial and evolving. The aim of this study is to evaluate the performance of confirmatory IGRAs in addition to tuberculin skin tests (TSTs) in high school students with TST-positive (TST+) results who have had contact with another student who had TB (referred to in this article as “contacts”) in TB outbreaks in a high BCG-vaccinated population.

Methods:  We conducted a retrospective observational study of contacts in five school TB outbreaks in South Korea. The progression rates of TB within 2 years were compared among the groups based on the results of TSTs and QuantiFERON-TB gold assays (QFT-Gs).

Results:  Among 1,826 contacts, 21 (1.2%) developed active TB. Of the untreated groups, the rate of progression to TB was higher in the group with TST-positive (TST+) results (6.1%, six of 99) than in that with TST-negative (TST–) results (0.6%, 10 of 1,556; P < .001). Among TST+ contacts, the rate of progression to TB was higher in the group with QFT-G-positive (QFT-G+) results (18.75%, six of 32) than that with QFT-G-negative (QFT-G) results (0%, 0 of 67; P = .001). None of the 67 contacts with TST+/QFT-G results progressed to active TB.

Conclusions:  The addition of a confirmatory IGRA for TST+ contacts could effectively focus the targeting of LTBI treatment to fewer contacts in an intermediate-incidence setting in a high BCG-vaccinated population.

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