Serial interferon-gamma release assays after rifampicin prophylaxis in a tuberculosis outbreak.

Abstract

Even though some studies have reported the results of serial interferon-gamma release assays (IGRAs) during isoniazid prophylactic treatment, serial results have not been reported after rifampicin prophylaxis. A contact investigation was conducted after a tuberculosis (TB) outbreak in an accommodation facility. The tuberculin skin test (TST) and the QuantiFERON-TB Gold In-Tube (QFT-GIT) test were performed in 214 contacts with normal chest radiographs. Rifampicin prophylaxis was initiated in TST+/QFT-GIT+ subjects, and the QFT-GIT test was repeated upon completion of 4 months of rifampicin treatment. Among the 214 contacts, the TST and QFT-GIT test results were positive in 67.7% and 56.7%, respectively, and the agreement between the two tests was fair-to-good (78.3%, kappa=0.55, p<0.001). The QFT-GIT test was positive in 77% (97/126) of contacts with positive TST results. Rifampicin prophylaxis was completed in 81 subjects with good compliance. Among 74 subjects with valid serial QFT-GIT test results, IFN-gamma levels decreased in 97.3% (72/74) of the subjects and QFT-GIT test reversion (positive to negative) was achieved in 31 subjects (41.9%). Subjects without QFT-GIT test reversion had a significantly higher baseline TST induration sizes (18.3+/-4.8 vs. 14.9+/-3.4mm, p<0.01) and IFN-gamma levels (18.6+/-17.9 vs. 3.2+/-7.5IU/mL, p<0.01) than the subjects with QFT-GIT test reversion. Thus, IGRAs may be useful in evaluating the therapeutic response to rifampicin prophylaxis in TB contacts. However, considering that this was not a controlled study, a prospective controlled study is needed to determine whether rifampicin prophylaxis truly affects QFT-GIT reversion.

• Authors: Seung Heon Lee, Woo Jin Lew, Hee Jin Kim, Hyun-Kyung Lee, Young Min Lee, Chong Hee Cho, Eun Joo Lee, Dong Yeol Lee, Sung Weon Ryu, Soo Yeon Oh, Sin Ok Kim, Tae Sun Shim
• Journal: Respiratory medicine (Respir Med) Vol. 104 Issue 3 Pg. 448-53 (Mar 2010) ISSN: 1532-3064 [Electronic] England
• PMID: 19879123 (Publication Type: Journal Article)
• Copyright: Copyright 2009 Elsevier Ltd. All rights reserved.

Chemical References

• Antitubercular Agents
• Interferon-gamma
• Rifampin

Topics

• Adolescent
• Adult
• Aged
• Antitubercular Agents (therapeutic use)
• Disease Outbreaks
• Female
• Humans
• Interferon-gamma (immunology)
• Latent Tuberculosis (diagnosis, drug therapy, immunology)
• Male
• Middle Aged
• Republic of Korea
• Rifampin (therapeutic use)
• Tuberculin Test (methods)
• Tuberculosis, Pulmonary (diagnosis, drug therapy, immunology)
• Young Adult