体外干扰素- γ释放试验对尼日利亚Okada社区表面健康个体中潜伏性结核感染的免疫诊断潜力

B. O. Akinshipe, Peter Chinedu Ezeani, K. Digban, F. A. Ehiaghe, E. Adedeji, Joy Imuetinya Ehiaghe
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引用次数: 2

摘要

全球结核病控制的一个主要挑战是潜伏性结核感染的诊断和治疗。在没有任何诊断LTBI的参考标准测试的情况下,本研究开始比较目前两种基于免疫的测试,结核菌素皮肤试验(TST)和Quantiferon-TB金管(QFT-GIT) ELISA在LTBI诊断中的性能。对来自尼日利亚江户州冈田社区的196名表面健康志愿者的两组诊断结果在年龄、职业、bcg疫苗接种情况、既往TST和吸烟史方面进行了比较。总体而言,通过QFT-GIT测试和TST诊断LTBI的受试者分别为56例(28.6%)和81例(41.3%)。通过QFT-GIT测试评估的LTBI患病率在未接种bcg的人群中显著高于接种bcg的人群(X2=18.79, df=1, p=0.0001)。职业类别的一致性(QFT-GIT+ve/TST+ve)最高(Ʀ=-0.009, p=0.747),不一致性(QFT-GIT -ve /TST+ve)最高的是bcg疫苗接种状态(Ʀ=-0.194, p=0.046)。两种检测结果的差异是由于TST结果假阳性高,这直接反映了研究人群中卡介苗接种水平高(90.8%)。建议在卡介苗接种率高的结核病流行社区将两步检测方法,即使用QFT-GIT检测作为TST初步阳性筛查后LTBI的确证试验,引入结核病控制策略。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Immunodiagnostic Potential of an In-Vitro Interferon-Gamma Release Assay for Latent Tuberculosis Infection Among Apparently Healthy Individuals in Okada Community, Nigeria
A major challenge in the global Tuberculosis (TB) control is the diagnosis and treatment of Latent Tuberculosis Infection (LTBI). In the absence of any reference standard test for the diagnosis of LTBI, this study set out to compare the performance of the two current immune-based tests, Tuberculin Skin Test (TST) and Quantiferon–TB Gold In–Tube (QFT-GIT) ELISA in the diagnosis of LTBI. Two sets of diagnostic results for 196 apparently healthy volunteers from a cross-section of Okada Community, Edo State, Nigeria were compared in terms of age, occupation, BCG-vaccination status, prior TST and cigarette smoking history. Overall, 56 (28.6%) and 81 (41.3%) of the subjects were diagnosed with LTBI by the QFT-GIT test and TST respectively. The LTBI prevalence as assessed by the QFT-GIT test was significantly higher among the non-BCG-vaccinated, compared to the BCG-vaccinees (X2=18.79, df=1, p=0.0001). The highest concordance (QFT-GIT+ve/TST+ve) was found in the occupation categories (Ʀ=-0.009, p=0.747) and the highest discordance(QFT-GIT –ve/TST +ve) was with respect to the BCG-vaccination status (Ʀ=-0.194, p=0.046).The disparity in the performance of the two tests is attributable to the high false – positive TST results, which is a direct reflection of high (90.8%) BCG vaccination level among the study population. It is advocated that the two-step testing approach, using the QFT-GIT assay as a confirmatory test for LTBI after initial positive screening by the TST, be introduced into the TB control strategy in TB – laden communities with high BCG vaccination coverage.
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