Comparison of QFT-IT and QFT-Plus for Detecting Latent Tuberculosis in HIV-Infected Iranian Patients
Novelty in Biomedicine,
Vol. 13 No. 3 (2025),
27 Mordad 2025
,
Page 162-166
https://doi.org/10.22037/nbm.v13i3.47687
Abstract
Background: Tuberculosis (TB) is a major public health issue, especially among Human immunodeficiency virus (HIV)-infected individuals, where early detection of latent tuberculosis infection (LTBI) is crucial. Interferon-gamma release assays (IGRAs), like quantiferon-TB gold "in tube" (QFT-IT) and QFT-Plus, are more accurate alternatives to the tuberculin skin test (TST). This study compares the diagnostic performance of QFT-IT and QFT-Plus for detecting LTBI in HIV patients in Iran.
Materials and Methods: A cross-sectional study was conducted at Masih Daneshvari Hospital, Iran’s national tuberculosis center, between 2020 and 2023. HIV-infected individuals were tested using both QFT-IT and QFT-Plus assays. Agreement between the two tests was evaluated using the kappa coefficient, and McNemar's test was used to assess discrepancies.
Results: Of the 100 HIV-infected patients, 93% demonstrated agreement between the two tests. However, 7% of participants showed discrepancies, with six patients testing negative on QFT-Plus but positive on QFT-IT. The kappa coefficient for agreement was 0.92, indicating high concordance between the two assays. McNemar's test revealed no significant difference in diagnostic performance.
Conclusion: Both QFT-IT and QFT-Plus exhibited strong agreement in detecting LTBI in HIV-infected Iranian patients, supporting their use as reliable diagnostic tools for LTBI screening in this population. Further studies are recommended to assess their utility in other settings and patient populations.
- Tuberculosis
- HIV
- LTBI
- QuantiFERON-TB
- Interferon-Gamma Release Assays
- Diagnostic Agreement
- Iran
How to Cite
References
World Health Organization. Global tuberculosis report 2024. Geneva: World Health Organization;2024
Shah, M. and S.E. Dorman, Latent tuberculosis infection. New England Journal of Medicine, 2021;385(24):2271-80.
Pawlowski, A., et al., Tuberculosis and HIV co-infection. PLoS pathogens, 2012. 8(2): p. e1002464.
Hamada, Y., et al., HIV-associated tuberculosis. International journal of STD & AIDS, 2021;32(9):780-90.
Wells, C.D., et al., HIV infection and multidrug-resistant tuberculosis—the perfect storm. The Journal of infectious diseases, 2007. 196(Supplement_1):S86-S107.
Nasiri, M.J., et al., Latent tuberculosis infection in transplant candidates: a systematic review and meta-analysis on TST and IGRA. Infection, 2019;47:353-61.
Sharma, S.K., et al., Comparison of TST and IGRA in diagnosis of latent tuberculosis infection in a high TB-burden setting. PloS one, 2017. 12(1): p. e0169539.
Campbell, J.R., et al., A systematic review on TST and IGRA tests used for diagnosis of LTBI in immigrants. Molecular diagnosis & therapy, 2015. 19: p. 9-24.
Pai, M. and M. Behr, Latent Mycobacterium tuberculosis infection and interferon-gamma release assays. Microbiology spectrum, 2016. 4(5): p. 10.1128/microbiolspec. tbtb2-0023-2016.
Pai, M., et al., Gamma interferon release assays for detection of Mycobacterium tuberculosis infection. Clinical microbiology reviews, 2014. 27(1): p. 3-20.
Sotgiu, G., et al., QuantiFERON TB Gold Plus for the diagnosis of tuberculosis: a systematic review and meta-analysis. Journal of Infection, 2019. 79(5): p. 444-453.
Pourakbari, B., et al., Comparison of the QuantiFERON-TB Gold Plus and QuantiFERON-TB Gold In-Tube interferon-γ release assays: A systematic review and meta-analysis. Advances in medical sciences, 2019. 64(2): p. 437-443.
Lee, J.-K., et al., Comparison of QuantiFERON-TB Gold Plus and QuantiFERON-TB Gold In-Tube tests for patients with active and latent tuberculosis: a prospective cohort study. Journal of Infection and Chemotherapy, 2021. 27(12): p. 1694-1699.
Zhang, Y., et al., Comparing the diagnostic performance of QuantiFERON-TB Gold Plus with QFT-GIT, T-SPOT. TB and TST: a systematic review and meta-analysis. BMC Infectious Diseases, 2023. 23(1): p. 40.
Shafeque, A., et al., Fourth-generation QuantiFERON-TB Gold Plus: what is the evidence? Journal of clinical microbiology, 2020. 58(9): p. 10.1128/jcm. 01950-19.
Wyndham-Thomas, C., et al., Implementation of latent tuberculosis screening in HIV care centres: evaluation in a low tuberculosis incidence setting. Epidemiology & Infection, 2016. 144(4): p. 703-711.
Goletti, D., et al., Latent tuberculosis infection screening in persons newly-diagnosed with HIV infection in Italy: a multicentre study promoted by the Italian Society of Infectious and Tropical Diseases. International Journal of Infectious Diseases, 2020. 92: p. 62-68.
White, H.A., et al., Latent tuberculosis infection screening and treatment in HIV: insights from evaluation of UK practice. Thorax, 2017. 72(2): p. 180-182.
Menzies, D., Screening for latent tuberculosis infection. JAMA Network Open, 2023. 6(5): p. e2312114-e2312114.
Pollock, K.M., et al., Comparison of screening strategies to improve the diagnosis of latent tuberculosis infection in the HIV-positive population: a cohort study. BMJ open, 2012. 2(2): p. e000762.
Buonsenso, D., et al., Accuracy of QuantiFERON-TB gold plus test for diagnosis of Mycobacterium tuberculosis infection in children. Journal of Clinical Microbiology, 2020. 58(6): p. 10.1128/jcm. 00272-20.
James, P.M., F.A. Ganaie, and R.L. Kadahalli, The performance of quantiferon-TB gold in-tube (QFT-IT) test compared to tuberculin skin test (TST) in detecting latent tuberculosis infection (LTBI) in the presence of HIV coinfection in a high TB-burden area with BCG-vaccinated population. Journal of the International Association of Providers of AIDS Care (JIAPAC), 2014. 13(1): p. 47-55.
Nienhaus, A., et al., Systematic review of cost and cost-effectiveness of different TB-screening strategies. BMC health services research, 2011. 11: p. 1-10.
- Abstract Viewed: 216 times
- pdf Downloaded: 52 times