Interferon gamma release assays for detection of latent Mycobacterium tuberculosis in older Hispanic people.

Interferon gamma release assays for detection of latent Mycobacterium tuberculosis in older Hispanic people.
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DOI:
10.1016/j.ijid.2021.08.014
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发表时间:
2021-10
期刊:
International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases
影响因子:
--
通讯作者:
Restrepo BI
Restrepo BI
中科院分区:
其他
文献类型:
--
作者:
Scordo JM;Aguillón-Durán GP;Ayala D;Quirino-Cerrillo AP;Rodríguez-Reyna E;Joya-Ayala M;Mora-Guzmán F;Ledezma-Campos E;Villafañez A;Schlesinger LS;Torrelles JB;Turner J;Restrepo BI

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干扰素γ释放试验(IGRA)用于检测成人中的潜伏性结核分枝杆菌(M.tb)感染(LTBI),但其在老年人中的性能尚未得到充分确定。我们评估了IGRA在老年西班牙裔近期结核病接触者(ReC)或社区对照(CoC)中的LTBI检测。在老年(≥60岁)和成年(18-50岁)西班牙裔人群中使用T-SPOT.TB和/或QuantiFERON-Gold管内或-Plus检测进行LTBI的横断面评估。我们招募了193名CoC(119名成人,74名老年人)和459名ReC(361名成人,98名老年人)。CoC组LTBI阳性率随年龄增加而增加(19%~ 59%,P<0.001),ReC组LTBI阳性率随年龄增加而增加(59%~ 69%,P=0.329)。老年人IGRA之间的一致性较低(Kappa 0.465 vs 0.688,成人)和更多的不确定结果(不确定/边界11.6% vs 5.8%,成人,P=0.012)。对于同时进行的IGRA,将不确定的结果分为阳性或阴性。IGRA对结核分枝杆菌肽的反应程度在不同年龄组之间相似,但对有丝分裂原的反应在老年人中较低。IGRA适用于老年人的LTBI检测。不一致和不确定的发现在老年人中更为普遍,但当使用不同的IGRA测试重复IGRA时,结果就会得到解决。
Interferon gamma release assays (IGRAs) are used to detect latent Mycobacterium tuberculosis (M.tb) infection (LTBI) in adults, but their performance in older people is not well-established. We evaluated IGRAs for LTBI detection in older Hispanic recent TB contacts (ReC) or community controls (CoC). Cross-sectional assessment of LTBI with T-SPOT.TB and/or QuantiFERON-Gold in-tube or –Plus assay in older (≥60 years) and adult (18–50 years) Hispanic people. We enrolled 193 CoC (119 adults, 74 older persons) and 459 ReC (361 adults, 98 older persons). LTBI positivity increased with age in CoC (19%–59%, P<0.001), but was similar in ReC (59%–69%, P=0.329). Older people had lower concordance between IGRAs (kappa 0.465 vs 0.688 in adults) and more inconclusive results (indeterminate/borderline 11.6% vs 5.8% in adults, P=0.012). With simultaneous IGRAs, inconclusive results were resolved as positive or negative with the other IGRA. The magnitude of response to M.tb peptides in IGRAs was similar among age groups, but responsiveness to mitogens was lower in older people. IGRAs are suitable for LTBI detection in older people. Discordant and inconclusive findings are more prevalent in older people, but results are resolved when IGRA is repeated with a different IGRA test.
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