Dynamic changes of interferon gamma release assay results with latent tuberculosis infection treatment. (November 2020)

• Record Type: Journal Article
• Authors: Xin, H.; Cao, X.; Zhang, H.; Liu, J.; Pan, S.; Li, X.; Guan, L.; Shen, F.; Liu, Z.; Wang, D.; Guan, X.; Yan, J.; Li, H.; Feng, B.; Zhang, M.; Yang, Q.; Jin, Q.; Gao, L.
• Is Part Of: Clinical microbiology and infection. Volume 26:Number 11(2020)
• Page Start: 1555.e1
• Page End: 1555.e7
• Publication Date: 2020-11
• Subjects: Latent tuberculosis infection -- Preventative treatment -- QFT-GIT reversion -- QFT-GIT serial tests -- Randomized controlled trial; Medical microbiology -- Periodicals; Diagnostic microbiology -- Periodicals; Communicable diseases -- Periodicals; Infection -- Periodicals; 616.01
• DOI: 10.1016/j.cmi.2020.02.009
• Languages: English
• ISSNs: 1198-743X

Abstract

Abstract: Objectives: Using QuantiFERON-TB Gold In-Tube (QFT-GIT) for monitoring tuberculosis (TB) and latent TB infection treatment effect is controversial. The present study aimed to evaluate the dynamic changes of interferon gamma (IFN-γ) levels along with latent TB infection treatment via a randomized controlled study. Methods: A total of 910 participants treated with 8 weeks of once-weekly rifapentine plus isoniazid (group A), 890 treated with 6 weeks of twice-weekly rifapentine plus isoniazid (group B) and 818 untreated controls (group C) were followed for 2 years to track active TB development. QFT-GIT tests were repeated three times for all groups: before treatment (T0), at completion of treatment (T1) and 3 months after completion of treatment (T2). Results: Similar rates of persistent QFT-GIT reversion were observed in groups A (19.0%, 173/910), B (18.5%, 165/890) and C (20.7%, 169/818) (p 0.512). The dynamic changes of IFN-γ levels were not statistically significant among the three groups. In treated participants, individuals with higher baseline IFN-γ levels showed increased TB occurrence (1.0%, 9/896) compared to those with lower baseline levels (0.2%, 2/904) (p 0.037). A similar but statistically insignificant trend was also observed in untreated controls (1.8% (7/400) vs. 0.5% (2/418), p 0.100). When TB cases were matched with non-TB cases on baseline IFN-γ levels, no significant differences were found with respect to the dynamic changes in IFN-γ levels with time, regardless of whether they received treatment. Conclusions: QFT-GIT reversion or decreased IFN-γ levels should not be used for monitoring host response to latent TB infection treatment.