Indeterminate results of a tuberculosis-specific interferon-  release assay in immunocompromised patients

摘要: To the Editors: Immunocompromised patients with various causes and degrees of immunodeficiencies, such as stem cell solid organ transplant recipients, autoimmune diseases, chronic renal failure or HIV-positive patients, are at increased risk progression from latent Mycobacterium tuberculosis infection to active disease. Therefore, screening for preventive treatment is recommended in this patient population. Tuberculosis-specific interferon (IFN)-γ release assays (TIGRAs) lacking cross-reactivity bovis bacille Calmette-Guerin have been introduced into routine diagnosis (LTBI) last few years a more specific alternative tuberculin skin test (TST). More recent results implicate that QuantiFERON®-TB Gold tube (QFT-G-IT; Cellestis, Carnegie, Australia) may better predict disease compared TST 1, 2. TIGRAs using stimulation T-cells phytohemagglutinin (PHA) positive control identification false negatives classification indeterminate be prediction LTBI immunocompromised where IFN-γ affected by immunosuppression. The growing list data existing on reliability TIGRAs show prevalence vary depending degree immunosuppression TIGRA used 3. In addition, PHA recall antigens use different secretion pathways 4, which differentially immunosuppressive conditions. Thus, an in-depth analysis factors influencing PHA-associated important assessment patients. Since group dependent independent not evaluated prospectively third generation QFT-G-IT test, we tested diverse conditions determine rate identify results. After approval …