Abstract：
BACKGROUND: The diagnosis of latent tuberculous infection (LTI) by IGRA continues to generate debate. Experience in the simultaneous use of 2 IGRA tests is scant. The aim of this study was to compare the results of 2 versions of QuantiFERON-TB Gold (In-Tube/Plus) with those of T-SPOT.TB, and to analyse the effectiveness of a dual strategy (T-SPOT.TB + QTF) for the diagnosis of LTI in an immunosuppressed population.
METHODS: We conducted a prospective study (May 2015-June 2017) that included 2999 immunosuppressed patients and/or candidates for biologics, in whom 2 simultaneous IGRA tests were performed: Group 1 (1535 patients): T-SPOT.TB + QuantiFERON-TB Gold-In-Tube (QTF-GIT); Group 2 (1464 patients): T-SPOT.TB + QuantiFERON-TB Gold Plus (QTF-Plus.
RESULTS: The concordance between QTF-GIT and T-SPOT.TB was 83.19% (κ = 0.532). The percentage of positive, negative, and indeterminate results were, respectively: 14.33% vs. 17.06%; 82.41% vs. 74.46%; and 3.25% vs. 8.46%. The concordance between QTF-Plus and T-SPOT.TB was 87.56% (κ = 0.609). The percentage of positive, negative, and indeterminate results were, respectively: 15.02% vs. 15.36%; 82.92% vs. 79.37%; and 2.04% vs. 5.25%. Discrepancies between T-SPOT.TB and QTF-Plus were 12.43%, suggesting that 103 patients were positive and another 79 were negative due exclusively to 1 of the 2 IGRAs.
CONCLUSIONS: Greater concordance was found between QTF-Plus and T-SPOT.TB than between QTF-GIT and T-SPOT.TB. However, we believe that the proportion of discrepancies between T-SPOT.TB and QTF-Plus is sufficiently important from a clinical point of view to justify the simultaneous use of 2 IGRA in this specific patient group.
METHODS: We conducted a prospective study (May 2015-June 2017) that included 2999 immunosuppressed patients and/or candidates for biologics, in whom 2 simultaneous IGRA tests were performed: Group 1 (1535 patients): T-SPOT.TB + QuantiFERON-TB Gold-In-Tube (QTF-GIT); Group 2 (1464 patients): T-SPOT.TB + QuantiFERON-TB Gold Plus (QTF-Plus.
RESULTS: The concordance between QTF-GIT and T-SPOT.TB was 83.19% (κ = 0.532). The percentage of positive, negative, and indeterminate results were, respectively: 14.33% vs. 17.06%; 82.41% vs. 74.46%; and 3.25% vs. 8.46%. The concordance between QTF-Plus and T-SPOT.TB was 87.56% (κ = 0.609). The percentage of positive, negative, and indeterminate results were, respectively: 15.02% vs. 15.36%; 82.92% vs. 79.37%; and 2.04% vs. 5.25%. Discrepancies between T-SPOT.TB and QTF-Plus were 12.43%, suggesting that 103 patients were positive and another 79 were negative due exclusively to 1 of the 2 IGRAs.
CONCLUSIONS: Greater concordance was found between QTF-Plus and T-SPOT.TB than between QTF-GIT and T-SPOT.TB. However, we believe that the proportion of discrepancies between T-SPOT.TB and QTF-Plus is sufficiently important from a clinical point of view to justify the simultaneous use of 2 IGRA in this specific patient group.
摘要：
背景：IGRA对潜伏性结核感染（LTI）的诊断一直存在争议。同时使用2个IGRA测试的经验很少。这项研究的目的是比较两种版本的QuantiFERON-TB金（In-ube/Plus）与T-SPOT的结果。TB,并分析双重战略的有效性(T-SPOT。TB+QTF）用于诊断免疫抑制人群中的LTI。
方法：我们进行了一项前瞻性研究（2015年5月至2017年6月），包括2999名免疫抑制患者和/或生物制剂候选人，同时进行了2次IGRA检查:第1组(1535例患者):T-SPOT.TB+QuantiFERON-TB金管（QTF-GIT）；第2组（1464例患者）：T-SPOT。TB+QuantiFERON-TBGoldPlus(QTF-Plus.
结果：QTF-GIT与T-SPOT的一致性。TB为83.19%(κ=0.532)。积极的百分比，负,不确定的结果是，分别为：14.33%与17.06%；82.41%与74.46%；3.25%与8.46%。QTF-Plus与T-SPOT的一致性。TB为87.56%(κ=0.609)。积极的百分比，负,不确定的结果是，分别为：15.02%与15.36%；82.92%与79.37%；2.04%与5.25%。T-SPOT之间的差异。TB和QTF-Plus分别为12.43%，提示103例患者为阳性,另外79例患者为阴性,完全是由于2例IGRAs中的1例.
结论：在QTF-Plus和T-SPOT之间发现更大的一致性。TB比QTF-GIT和T-SPOT之间。TB。然而,我们认为T-SPOT之间的比例差异。从临床角度来看，TB和QTF-Plus足够重要，足以证明在该特定患者组中同时使用2IGRA。
方法：我们进行了一项前瞻性研究（2015年5月至2017年6月），包括2999名免疫抑制患者和/或生物制剂候选人，同时进行了2次IGRA检查:第1组(1535例患者):T-SPOT.TB+QuantiFERON-TB金管（QTF-GIT）；第2组（1464例患者）：T-SPOT。TB+QuantiFERON-TBGoldPlus(QTF-Plus.
结果：QTF-GIT与T-SPOT的一致性。TB为83.19%(κ=0.532)。积极的百分比，负,不确定的结果是，分别为：14.33%与17.06%；82.41%与74.46%；3.25%与8.46%。QTF-Plus与T-SPOT的一致性。TB为87.56%(κ=0.609)。积极的百分比，负,不确定的结果是，分别为：15.02%与15.36%；82.92%与79.37%；2.04%与5.25%。T-SPOT之间的差异。TB和QTF-Plus分别为12.43%，提示103例患者为阳性,另外79例患者为阴性,完全是由于2例IGRAs中的1例.
结论：在QTF-Plus和T-SPOT之间发现更大的一致性。TB比QTF-GIT和T-SPOT之间。TB。然而,我们认为T-SPOT之间的比例差异。从临床角度来看，TB和QTF-Plus足够重要，足以证明在该特定患者组中同时使用2IGRA。
