The pros and cons of the QuantiFERON test for the diagnosis of tuberculosis, prediction of disease progression, and treatment monitoring
The pros and cons of the QuantiFERON test for the diagnosis of tuberculosis, prediction of disease progression, and treatment monitoring
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DOI：
10.1016/j.ijmyco.2016.02.005
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发表时间：
2016-06-01
影响因子：
1.2
通讯作者：
Pefura, Yone
中科院分区：
文献类型：
--
作者：
Ndzi, Elvis Ndukong;Nkenfou, Celine Nguefeu;Pefura, Yone
目的/背景：结核病(TB)是随着人类免疫缺陷病毒/艾滋病(HIV/AIDS)感染而再次出现的疾病。结核病感染的治疗于1959年被发现，通过各种方法诊断并使用抗生素治疗，仍然构成公共卫生问题。观察到了许多耐药和交叉耐药的情况。培养诊断被认为是标准方法，耗时太长(20-30天)，不适合肺外结核病。Quantiferon试验是一种基于血液的间接免疫分析方法。人们对这种新方法寄予了很大希望，因为它是基于血液的，许多研究团队都使用了它。我们讨论了这些不同的研究小组在结核病治疗过程中使用Quantiferon进行诊断、预测疾病进展或监测患者的结果。方法：检索PubMed上发表的文章和Google上发表的文献，检索关键词：诊断与结核病和Quantiferon；TB和Quantiferon与治疗监测；干扰素-c释放试验；疾病进展。结果：根据研究人群(民族、卡介菌疫苗的使用)和研究对象的免疫系统状态(人类免疫缺陷病毒免疫抑制、癌症药物治疗、高血压)，使用量子因子试验诊断结核病的结果是有争议的。此外，关于使用Quantiferon监测服用抗结核药物的结核病患者的研究结果也存在争议。此外，两种干扰素-c释放试验对移民密切接触者进展为结核病的预测阳性价值并不比结核菌素皮肤试验更好。结论：Quantiferon根据所研究人群的类型而有优势和局限性。建议通过在结核分枝杆菌抗原鸡尾酒中添加其他特异性蛋白来提高敏感性和特异性，并区分潜伏期和活动性结核。(C)2016年亚非分枝杆菌学会。爱思唯尔有限公司制作和主办。版权所有。
Objective/Background: Tuberculosis (TB) is a re-emerging disease with the advent of human immunodeficiency virus/AIDS infections. Discovered in 1959, diagnosed by various approaches and treated with antibiotics, the treatment of TB infection still poses public health concerns. Many cases of resistance and cross-resistance are observed. Diagnosis by culture, which is considered as the standard method, takes too long (20-30 days) and is not suitable for extrapulmonary TB. QuantiFERON test, which is an indirect immunoassay based on blood, was developed. Much hope was placed in this new approach because it is based on blood, and many research teams have used it. We discuss the results of these different research groups who have used QuantiFERON for diagnosis, prediction of disease progression, or monitoring patients during the treatment of TB.Methods: Articles published in PubMed and documents published on Google were searched with the keywords: diagnosis and TB and QuantiFERON; TB and QuantiFERON and therapeutic monitoring; interferon-c release assay; disease progression. These articles were read and analyzed.Results: The results were controversial with regards to using the QuantiFERON test for the diagnosis of TB according to the study population (ethnic group, bacillus Calmette-Guerin vaccine use) and according to the state of the immune system of the people studied (human immunodeficiency virus immunosuppression in cancer medication, hypertension). Also, research findings were controversial with regards to using QuantiFERON for monitoring TB patients on anti-TB medications. Also, the predictive positive value for the progression to TB among immigrant close contacts of both interferon-c release assays was not better than that of the tuberculin skin test.Conclusion: The QuantiFERON has advantages and limitations depending on the type of population studied. Recommendations are made to improve the sensitivity and specificity and to differentiate between latent and active TB by adding other specific proteins in the Mycobacterium tuberculosis antigen cocktail. (C) 2016 Asian-African Society for Mycobacteriology. Production and hosting by Elsevier Ltd. All rights reserved.