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在结核接触调查中,QuantiFERON-TB Gold Plus的逆转:一个前性的多中心队列研究
Sandra Pérez-Recio1, Maria D Grijota-Camino1,2, Luis Anibarro3
1Tuberculosis Unit, Department of Infectious Diseases, Bellvitge University Hospital-Bellvitge Biomedical Research Institute (IDIBELL), L'Hospitalet de Llobregat, Barcelona, Spain.
PloS one
|August 30, 2023
概括
在结核病 (TB) 接触调查期间,QuantiFERON-TB Gold Plus (QFT-Plus) 逆转很少发生. 作为减少预防性结核病治疗的策略,不支持重新测试最初QFT-Plus阳性结果的个体.
科学领域:
- 传染性疾病 传染性疾病
- 免疫学 免疫学 免疫学
- 公共卫生 公共卫生
背景情况:
- 干扰素-释放测试 (IGRA) 用于结核病 (TB) 的诊断.
- 在各种临床环境中观察到IGRA逆转.
- 量子费隆-结核病黄金加 (QFT-Plus) 试验是一种广泛使用的IGRA.
研究的目的:
- 为了确定结核病接触调查中的QFT-Plus复发率.
- 评估QFT-Plus逆转作为一种减少不必要的预防性结核病治疗的策略.
主要方法:
- 一项前性多中心队列研究,涉及肺结核患者的免疫能力强的成年接触者.
- 接触者初始QFT-Plus阳性结果 (QFT-i) 在4周内再次测试 (QFT-1).
- 4周后,与QFT-1结果负的接触者再次进行了测试 (QFT-2),以评估持续的逆转.
主要成果:
- 在415名接触者中,96人 (23.1%) 首次呈QFT-Plus检测阳性.
- 10名接触者呈QFT-1阴性结果,其中4人 (4.2%) 显示持续逆转 (阴性QFT-2).
- 持续的逆转与初始IFN-γ度低 (0.350.99 IU/mL) 相关.
结论:
- 在结核病接触调查中,QFT-Plus逆转并不常见.
- 这些发现不支持重新测试阳性病例,以减少预防性治疗决策.
- 目前的结核病预防治疗策略不应该依赖于QFT-Plus逆转.
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