1. Clinical variables associated with indeterminate QuantiFERON®-TB Gold assay results: role of pre-incubation delay
- Author
-
M R Al-Turkmani, Lokinendi V. Rao, and Vladislav V. Makarenko
- Subjects
030203 arthritis & rheumatology ,Pulmonary and Respiratory Medicine ,medicine.medical_specialty ,Clinical variables ,business.industry ,QUANTIFERON-TB GOLD ,Retrospective cohort study ,bacterial infections and mycoses ,medicine.disease ,03 medical and health sciences ,Liver disease ,0302 clinical medicine ,Infectious Diseases ,Internal medicine ,Cohort ,Pre incubation ,medicine ,030212 general & internal medicine ,Hypoalbuminemia ,business ,Indeterminate - Abstract
SETTING The QuantiFERON®-TB Gold (QFT) assay is an interferon-gamma release assay used for the clinical diagnosis of latent tuberculous infection. Relatively high rates of indeterminate results are a significant downside of the test. OBJECTIVE To evaluate clinical variables associated with lower QFT-indeterminate rates after reducing pre-incubation delay. DESIGN In 2016, a new protocol of on-site incubation of QFT samples, followed by analysis at the outside laboratory, was implemented, resulting in much shorter pre-incubation delay of the samples. We retrospectively identified 3583 patients who underwent QFT before and after implementation of the new protocol. Patient records were scrutinized and QFT results were evaluated with respect to associated clinical conditions. RESULTS The patients were analyzed by dividing them into two cohorts based on maximum pre-incubation time (standard vs. immediate). Monthly indeterminate results dropped from 12.7% ± 0.02 in the standard cohort to 5.5% ± 0.03 in the immediate cohort (P < 0.001). A significant reduction in relative indeterminate rates was found in the immediate cohort patients with immunocompromised state, autoimmune conditions, liver disease and hypoalbuminemia. No difference was identified in patients with malignancies and renal failure. CONCLUSION Limiting the pre-incubation time to 1 h maximum significantly improved QFT performance, especially in patients from certain clinical categories.
- Published
- 2018
- Full Text
- View/download PDF