Specificity of the Tuberculin Skin Test and the T-SPOT.TB Assay Among Students in a Low–Tuberculosis Incidence Setting
Specificity of the Tuberculin Skin Test and the T-SPOT.TB Assay Among Students in a Low–Tuberculosis Incidence Setting
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DOI：
10.1080/07448481.2011.580029
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发表时间：
2012-01
影响因子：
2.4
通讯作者：
E. Talbot;D. Harland;W. Wieland-Alter;Sherry L. Burrer;L. Adams
中科院分区：
文献类型：
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作者：
E. Talbot;D. Harland;W. Wieland-Alter;Sherry L. Burrer;L. Adams
摘要 目的：干扰素-γ释放测定（IGRA）是检测潜伏结核分枝杆菌感染（LTBI）的重要工具。大学健康中心关于 IGRA 特异性的数据不足，其中大多数使用结核菌素皮试 (TST) 筛查学生的 LTBI。参与者：结核病低发病率大学健康中心的学生。方法：对未来招募的学生进行 TST 和 T-SPOT.TB。使用问卷评估结核病暴露风险：假设低风险者没有 LTBI，以便计算测试特异性。结果：在 184 名注册学生中，143 名获得了 TST 和 T-SPOT.TB 的结果。测试的一致性为 97%（kappa 统计量 0.717；95% 置信区间，0.399–1.00）。在 124 名低风险学生中，TST 和 T-SPOT.TB 的特异性分别为 98.4% 和 100%。结论：T-SPOT.TB 在低风险学生中特异性较高。需要进行其他研究，例如使用 T-SPOT.TB 作为 TST 的单一或验证性测试的成本效益分析，以促进 LTBI 筛查政策决策。
Abstract Objective: Interferon-γ release assays (IGRAs) are an important tool for detecting latent Mycobacterium tuberculosis infection (LTBI). Insufficient data exist about IGRA specificity in college health centers, most of which screen students for LTBI using the tuberculin skin test (TST). Participants: Students at a low–TB incidence college health center. Methods: TST and T-SPOT.TB were performed on prospectively recruited students. TB exposure risk was assessed using a questionnaire: Those at low risk were assumed to not have LTBI in order to calculate test specificity. Results: Of 184 students enrolled, 143 had results available for both TST and T-SPOT.TB. Agreement of the tests was 97% (kappa statistic 0.717; 95% confidence interval, 0.399–1.00). Among 124 low-risk students, specificity for TST and T-SPOT.TB were 98.4% and 100%, respectively. Conclusions: T-SPOT.TB specificity was high among low-risk students. Additional studies such as cost-effectiveness analyses using T-SPOT.TB as a single or confirmatory test to TST are needed to contribute to LTBI screening policy decisions.