Role of confirmatory interferon-gamma release assays in school outbreaks of tuberculosis in South Korea

H. J. Kim, G. H. Lee, S. Ryoo, S. Y. Oh, J. B. Lee, Je Hyeong Kim, Chol Shin, Seung Heon Lee

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

OBJECTIVE: To investigate the usefulness of confirmatory QuantiFERON® (QFT) testing among tuberculin skin test (TST) positive contacts to diagnose latent tuberculous infection (LTBI) in tuberculosis (TB) outbreaks among adolescents. DESIGN: We used the Korean national claims database to identify the development of active TB disease in relation to initial TST (cut-off 10 mm induration) and subsequent QFT results. RESULTS: A total of 7475 contacts in 89 schools were divided into four groups: TST-(n = 5714), TST+/QFT+(n = 534), TST+/QFT- (n = 697) and TST+ only (n = 530). The mean duration of follow-up was 3.9 ± 0.9 years. For contacts with no LTBI treatment (n = 6868), TB incidence rates per 1000 person-years (py) and the adjusted hazard ratio (HR) compared with TST-individuals were as follows: TST+/QFT+, 66.2/1000 py (HR 35.59, 95%CI 14.03-90.31, P < 0.001); TST+ only, 10.1/1000 py (HR 5.16, 95%CI 2.91-9.17, P < 0.001); TST+/QFT-, 4.0/1000 py (HR 2.05, 95%CI 1.05-4.01, P = 0.035); and TST- 2.0/1000 py. The TB progression rate was significantly higher in TST+/QFT+ than in TST+/QFT-individuals (HR 16.82, 95 CI 5.84-48.46, P < 0.001). CONCLUSION: A confirmatory QFT for TST+contacts could reduce the number of candidates for LTBI treatment after school TB outbreaks.

Original languageEnglish
Pages (from-to)576-581
Number of pages6
JournalInternational Journal of Tuberculosis and Lung Disease
Volume19
Issue number5
DOIs
Publication statusPublished - 2015 May 1

Fingerprint

Interferon-gamma Release Tests
Republic of Korea
Tuberculin Test
Skin Tests
Disease Outbreaks
Tuberculosis
Infection

Keywords

  • Latent tuberculous infection
  • Quanti-FERON test
  • TB outbreaks
  • Tuberculin skin test

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine
  • Infectious Diseases

Cite this

Role of confirmatory interferon-gamma release assays in school outbreaks of tuberculosis in South Korea. / Kim, H. J.; Lee, G. H.; Ryoo, S.; Oh, S. Y.; Lee, J. B.; Kim, Je Hyeong; Shin, Chol; Lee, Seung Heon.

In: International Journal of Tuberculosis and Lung Disease, Vol. 19, No. 5, 01.05.2015, p. 576-581.

Research output: Contribution to journalArticle

@article{37dace532357431c9e7878cc6d5d045c,
title = "Role of confirmatory interferon-gamma release assays in school outbreaks of tuberculosis in South Korea",
abstract = "OBJECTIVE: To investigate the usefulness of confirmatory QuantiFERON{\circledR} (QFT) testing among tuberculin skin test (TST) positive contacts to diagnose latent tuberculous infection (LTBI) in tuberculosis (TB) outbreaks among adolescents. DESIGN: We used the Korean national claims database to identify the development of active TB disease in relation to initial TST (cut-off 10 mm induration) and subsequent QFT results. RESULTS: A total of 7475 contacts in 89 schools were divided into four groups: TST-(n = 5714), TST+/QFT+(n = 534), TST+/QFT- (n = 697) and TST+ only (n = 530). The mean duration of follow-up was 3.9 ± 0.9 years. For contacts with no LTBI treatment (n = 6868), TB incidence rates per 1000 person-years (py) and the adjusted hazard ratio (HR) compared with TST-individuals were as follows: TST+/QFT+, 66.2/1000 py (HR 35.59, 95{\%}CI 14.03-90.31, P < 0.001); TST+ only, 10.1/1000 py (HR 5.16, 95{\%}CI 2.91-9.17, P < 0.001); TST+/QFT-, 4.0/1000 py (HR 2.05, 95{\%}CI 1.05-4.01, P = 0.035); and TST- 2.0/1000 py. The TB progression rate was significantly higher in TST+/QFT+ than in TST+/QFT-individuals (HR 16.82, 95 CI 5.84-48.46, P < 0.001). CONCLUSION: A confirmatory QFT for TST+contacts could reduce the number of candidates for LTBI treatment after school TB outbreaks.",
keywords = "Latent tuberculous infection, Quanti-FERON test, TB outbreaks, Tuberculin skin test",
author = "Kim, {H. J.} and Lee, {G. H.} and S. Ryoo and Oh, {S. Y.} and Lee, {J. B.} and Kim, {Je Hyeong} and Chol Shin and Lee, {Seung Heon}",
year = "2015",
month = "5",
day = "1",
doi = "10.5588/ijtld.14.0636",
language = "English",
volume = "19",
pages = "576--581",
journal = "International Journal of Tuberculosis and Lung Disease",
issn = "1027-3719",
publisher = "International Union against Tubercul. and Lung Dis.",
number = "5",

}

TY - JOUR

T1 - Role of confirmatory interferon-gamma release assays in school outbreaks of tuberculosis in South Korea

AU - Kim, H. J.

AU - Lee, G. H.

AU - Ryoo, S.

AU - Oh, S. Y.

AU - Lee, J. B.

AU - Kim, Je Hyeong

AU - Shin, Chol

AU - Lee, Seung Heon

PY - 2015/5/1

Y1 - 2015/5/1

N2 - OBJECTIVE: To investigate the usefulness of confirmatory QuantiFERON® (QFT) testing among tuberculin skin test (TST) positive contacts to diagnose latent tuberculous infection (LTBI) in tuberculosis (TB) outbreaks among adolescents. DESIGN: We used the Korean national claims database to identify the development of active TB disease in relation to initial TST (cut-off 10 mm induration) and subsequent QFT results. RESULTS: A total of 7475 contacts in 89 schools were divided into four groups: TST-(n = 5714), TST+/QFT+(n = 534), TST+/QFT- (n = 697) and TST+ only (n = 530). The mean duration of follow-up was 3.9 ± 0.9 years. For contacts with no LTBI treatment (n = 6868), TB incidence rates per 1000 person-years (py) and the adjusted hazard ratio (HR) compared with TST-individuals were as follows: TST+/QFT+, 66.2/1000 py (HR 35.59, 95%CI 14.03-90.31, P < 0.001); TST+ only, 10.1/1000 py (HR 5.16, 95%CI 2.91-9.17, P < 0.001); TST+/QFT-, 4.0/1000 py (HR 2.05, 95%CI 1.05-4.01, P = 0.035); and TST- 2.0/1000 py. The TB progression rate was significantly higher in TST+/QFT+ than in TST+/QFT-individuals (HR 16.82, 95 CI 5.84-48.46, P < 0.001). CONCLUSION: A confirmatory QFT for TST+contacts could reduce the number of candidates for LTBI treatment after school TB outbreaks.

AB - OBJECTIVE: To investigate the usefulness of confirmatory QuantiFERON® (QFT) testing among tuberculin skin test (TST) positive contacts to diagnose latent tuberculous infection (LTBI) in tuberculosis (TB) outbreaks among adolescents. DESIGN: We used the Korean national claims database to identify the development of active TB disease in relation to initial TST (cut-off 10 mm induration) and subsequent QFT results. RESULTS: A total of 7475 contacts in 89 schools were divided into four groups: TST-(n = 5714), TST+/QFT+(n = 534), TST+/QFT- (n = 697) and TST+ only (n = 530). The mean duration of follow-up was 3.9 ± 0.9 years. For contacts with no LTBI treatment (n = 6868), TB incidence rates per 1000 person-years (py) and the adjusted hazard ratio (HR) compared with TST-individuals were as follows: TST+/QFT+, 66.2/1000 py (HR 35.59, 95%CI 14.03-90.31, P < 0.001); TST+ only, 10.1/1000 py (HR 5.16, 95%CI 2.91-9.17, P < 0.001); TST+/QFT-, 4.0/1000 py (HR 2.05, 95%CI 1.05-4.01, P = 0.035); and TST- 2.0/1000 py. The TB progression rate was significantly higher in TST+/QFT+ than in TST+/QFT-individuals (HR 16.82, 95 CI 5.84-48.46, P < 0.001). CONCLUSION: A confirmatory QFT for TST+contacts could reduce the number of candidates for LTBI treatment after school TB outbreaks.

KW - Latent tuberculous infection

KW - Quanti-FERON test

KW - TB outbreaks

KW - Tuberculin skin test

UR - http://www.scopus.com/inward/record.url?scp=84928893476&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84928893476&partnerID=8YFLogxK

U2 - 10.5588/ijtld.14.0636

DO - 10.5588/ijtld.14.0636

M3 - Article

C2 - 25868027

AN - SCOPUS:84928893476

VL - 19

SP - 576

EP - 581

JO - International Journal of Tuberculosis and Lung Disease

JF - International Journal of Tuberculosis and Lung Disease

SN - 1027-3719

IS - 5

ER -