Observational Study of QuantiFERON？-TB Gold In-Tube Assay in Tuberculosis Contacts in a Low Incidence Area 英文参考文献.docVIP

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Observational Study of QuantiFERON？-TB Gold In-Tube Assay in Tuberculosis Contacts in a Low Incidence Area 英文参考文献.doc

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Observational Study of QuantiFERON？-TB Gold In-Tube Assay in Tuberculosis Contacts in a Low Incidence Area 英文参考文献

ObservationalStudyofQuantiFERONH-TBGoldIn-Tube AssayinTuberculosisContactsinaLowIncidenceArea EmmanuelBergot1,2,3*,EglantineHaustraete1,BrigitteMalbruny4{,RomainMagnier1 ,Marie- AnneSalau¨n3,Ge′rardZalcman1,2 1Servicedepneumologie,CHUdeCaen,Caen,France,2UMR1086,CancersetPre′vention,CHUdeCaen,Caen,France,3CentredePre′ventiondesMaladiesInfectieuses, Caen,France,4Servicedemicrobiologie,CHUdeCaen,Caen,France Abstract Background:QuantiFERONH-TBGoldin-Tube(QFT)assayisarecentlydevelopedtesttoassesslatenttuberculosisinfection in contagious tuberculosis (TB) contact subjects. To assess the QFT assay in recently exposed contacts of active tuberculosis patients in a French area with low TB incidence but high Bacille Calmette-Guerin coverage, and evaluate progressionratestoTBdisease. Methodology/Principal Findings: Between January 2007 and December 2009, 687 contacts of culture-confirmed tuberculosiscasesunderwenttheQFTassay,withtuberculinskintest(TST)in473,anda34monthsmeanfollow-up.Of687 contacts,148wereQFTpositive,while526werenegativeand13indeterminate.QFTwaspositivein35%ofindividualswith TST$10mm,47.5%withTST$15mmorphlyctenular,butin21%ofcasesinwhichtwo-stepTST(M0andM3)remained negative.Conversely,QFTwasnegativein69%ofcaseswithtwo-stepTSTshowingconversionfromnegativetopositive.All indeterminate QFT were associated with TST induration ,10mm in diameter. For 29 QFT-positive subjects, no chemoprophylaxis was given due to medical contraindications. Of the remaining 119 QFT-positive contacts, 97accepted chemoprophylaxis(81.5%),and79(81.4%)completedthetreatment.TwocontactsprogressedtoTBdisease:onesubject wasQFTpositiveandhaddeclinedchemoprophylaxis,whiletheotheronewasQFTnegative.QFTpositivepredictivevalue forprogressiontoTBwas1.96%(1/51)witha99.8%(525/526)negativepredictivevalue. Conclusions/Significance:OurresultsconfirmthesafetyoftheQFT-basedstrategyforassessingtheTBchemoprophylaxis indication,asonlyonecontactdevelopedTBdiseaseoutof526QFT-negativesubjects. Citation:BergotE,