Abstract：
Whole T cell interferon gamma release assays such as QuantiFERON-TB Gold Plus (QTF-TB) are used to evaluate Mycobacterium tuberculosis complex (MTC) exposure but fail to discriminate latent tuberculosis infection (LTBI) from active disease. In this study conducted in a low-burden area, 1215 patients presenting MTC risk and tested both for QTF-TB and mycobacterial infection (microscopy, culture, and/or PCR) were selected, as well as 1298 controls screened with QTF-TB before medical recruitment. The humoral response (LIODetect®TB-ST) was further evaluated in 199 selected patients. In patients with active disease, MTC positivity (culture and/or PCR with species identification) was associated with QTF-TB positivity (45/56, 80.4 %). Although QTF-TB1/TB2 peptides were not suitable for discriminating against active MTC disease from LTBI, the cut-off value of 4.4 IFN-γ IU/mL produced the best diagnostic performance for MTC detection. Lower levels of QTF-TB were reported among patients with isolated active pulmonary MTC as compared to a lymph-nodal location and a disseminated form. Next, antibodies were detected in 4/55 (7.3 %) active MTC disease cases, while negative in cases of LTBI and indeterminate/negative QTF-TB. In conclusion, the added value to combine cellular (QTF-TB) and humoral (LIODetect®TB-ST) assays to predict an active MTC disease is limited.
摘要：
全T细胞干扰素γ释放测定，例如QuantiFERON-TBGoldPlus（QTF-TB）用于评估结核分枝杆菌复合体（MTC）的暴露，但无法区分潜伏性结核感染（LTBI）与活动性疾病。在这项在低负担地区进行的研究中，1215名患者存在MTC风险，并进行了QTF-TB和分枝杆菌感染测试（显微镜，文化,和/或PCR)被选择，以及在医疗招募前接受QTF-TB筛查的1298名对照。在199名选定的患者中进一步评估了体液反应(LIODetect®TB-ST)。在患有活动性疾病的患者中，MTC阳性（培养和/或带有物种鉴定的PCR）与QTF-TB阳性相关（45/56，80.4％）。尽管QTF-TB1/TB2肽不适合区分活动性MTC疾病和LTBI，4.4IFN-γIU/mL的截断值对MTC检测产生最佳诊断性能.与淋巴结位置和播散形式相比，孤立的活动性肺MTC患者的QTF-TB水平较低。接下来,在4/55（7.3％）活动性MTC疾病病例中检测到抗体，而在LTBI和不确定/阴性QTF-TB的情况下为阴性。总之,结合细胞(QTF-TB)和体液(LIODetect®TB-ST)检测来预测活动性MTC疾病的附加值是有限的.
