结核素皮肤测试和干扰素-γ释放试验在预测结核病疾病中的比较
Tracy Ayers1, Andrew N Hill1, Julia Raykin2
1Division of Tuberculosis Elimination, National Center for HIV, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia.
JAMA network open
|April 3, 2024
概括
干扰素释测试 (IGRA) 在预测结核病 (TB) 疾病发展方面明显优于结核素皮肤测试 (TST). IGRA提供了增强的预测价值,有助于结核病预防战略.
科学领域:
- 传染性疾病 传染性疾病
- 诊断的准确性 诊断的准确性
- 公共卫生 公共卫生
背景情况:
- 在美国消除结核病 (TB) 需要精确的测试来识别患有疾病进展风险的个体.
- 结核素皮肤测试 (TST) 和干扰素释测试 (IGRA) 在预测美国结核病方面的比较性能尚未得到充分证实.
研究的目的:
- 为了比较TST与两个IGRA (QuantiFERON-TB Gold In-Tube [QFT-GIT]和SPOT.TB [TSPOT]) 的预测性能,用于高风险人群中发生的结核病.
- 为了评估与TST一起使用第二次测试的增量值.
主要方法:
- 一项前性诊断研究,涉及10个美国地点的22020名高风险参与者 (2012-2020年).
- 在招生时与TST,QFT-GIT和TSPOT同时进行测试.
- 参与者被跟踪了2年,数据分析于2023年6月进行.
主要成果:
- 在预测发生的结核病 (PPV比率分别为1.65和1.47) 方面,IGRAs (TSPOT和QFT-GIT) 的表现明显优于TST.
- 积极的IGRA结果提供了一个统计学上显著的增量增加的积极预测值 (PPV),当TST也是积极的.
- 在129名参与者 (0.6%) 中发现了结核病,其中42例是TB病例.
结论:
- 与TST相比,IGRA在预测事件结核病方面表现优越.
- 与TST结合使用IGRA显著提高了结核病的预测能力.
- 这些发现支持使用IGRA来改善有关结核病预防治疗的决策.
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