Interferon-¥ã Enzyme-Linked Immunospot Assay in Patients with Tuberculosis and Healthy Adults
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±èöȫ(Kim Cheol-Hong) - Hallym University College of Medicine Department of Internal Medicine
±èÁ¾¿±(Kim Jong-Yeop) - Hallym University College of Medicine Department of Internal Medicine
Ȳ¿ëÀÏ(Hwang Yong-Il) - Hallym University College of Medicine Department of Internal Medicine
ÀÌâ·ü(Lee Chang-Youl) - Hallym University College of Medicine Department of Internal Medicine
ÃÖÁ¤Èñ(Choi Jeong-Hee) - Hallym University College of Medicine Department of Internal Medicine
¹Ú¿ë¹ü(Park Yong-Bum) - Hallym University College of Medicine Department of Internal Medicine
Àå½ÂÈÆ(Jang Seung-Hun) - Hallym University College of Medicine Department of Internal Medicine
¿ìÈïÁ¤(Woo Heung-Jeong) - Hallym University College of Medicine Department of Internal Medicine
±èµ¿±Ô(Kim Dong-Gyu) - Hallym University College of Medicine Department of Internal Medicine
ÀÌ¸í±¸(Lee Myung-Goo) - Hallym University College of Medicine Department of Internal Medicine
ÇöÀαÔ(Hyun In-Gyu) - Hallym University College of Medicine Department of Internal Medicine
Á¤±â¼®(Jung Ki-Suck) - Hallym University College of Medicine Department of Internal Medicine
±èÇö¼ö(Kim Hyun-Soo) - Hallym University College of Medicine Department of Laboratory Medicine
Abstract
Background: Interferon-¥ã assays based on tuberculosis (TB)-specific antigens have been utilized for diagnosing and ruling out latent TB and active TB, but their utility is still limited for TB incidence countries. The aim of this study is to understand the clinical utility of enzyme-linked immunospot (ELISpot) assays among patients with clinically suspected TB and healthy adults in clinical practices and community-based settings.
Materials and Methods: The ELISpot assays (T SPOT.TB, Oxford Immunotec, UK) were prospectively performed in 202 patients. After excluding those with indeterminate results, 196 were included for analysis: 41 were TB patients, 93 were non-TB patients, and 62 were healthy adults.
Results: The sensitivity and negative predictive values of the T SPOT.TB assays for the diagnosis of TB were 87.8% and 89.1%, respectively, among patients with suspected TB. The agreement between the tuberculin skin test (10-mm cutoff) and the T SPOT.TB assay was 66.1% (kappa=0.335) in all participants and 80.0% (kappa=0.412) in TB patients. Among those without TB (n=155), a past history of TB and fibrotic TB scar on chest X-rays were significant factors that yielded positive T SPOT.TB results. There was a significant difference in the magnitude of T SPOT.TB spot counts between TB patients and non-TB patients or healthy adults.
Conclusion: The T SPOT.TB assay appeared to be a useful test for the diagnostic exclusion of TB. A positive result, however, should be cautiously interpreted for potential positives among those without active TB in intermediate TB incidence areas.
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Enzyme-Linked Immunospot Assay, Interferon-gamma, Tuberculosis
KMID :
0383820140760010023
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