Evaluation of adapted whole-blood interferon-γ release assays for the diagnosis of pleural tuberculosis

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dc.contributor.authorChegou N.N.
dc.contributor.authorWalzl G.
dc.contributor.authorBolliger C.T.
dc.contributor.authorDiacon A.H.
dc.contributor.authorVan Den Heuvel M.M.
dc.date.accessioned2011-05-15T15:57:31Z
dc.date.available2011-05-15T15:57:31Z
dc.date.issued2008
dc.description.abstractBackground: Pleural tuberculosis (TB) remains difficult to diagnose despite numerous diagnostic tools. Recently, in vitro interferon (IFN)-γ-based assays have been introduced in the diagnosis of latent TB, but these techniques have not been established in the diagnosis of active TB disease, including pleural TB. Objectives: It was the aim of this study to assess the accuracy of the commercially available QuantiFERON® TB Gold assay and adapted variants of the assay, using pleural fluid or isolated pleural fluid cells for the diagnosis of pleural TB. Methods: We recruited 66 consecutive patients with a pleural effusion of unknown cause presenting at a tertiary academic health care centre in Cape Town, South Africa, a high prevalence area of TB. Blood and pleural fluid were collected at presentation for IFN-γ assays and the results evaluated for diagnostic accuracy. Results: The clinical diagnosis was TB in 30 (46%), malignancy in 20 (30%), parapneumonic effusion/empyema in 8 (12%) and effusion due to other causes in 8 patients (12%). Ex vivo pleural fluid IFN-γ levels accurately identified TB in all patients and were superior to the QuantiFERON In Tube assay using blood and pleural fluid (73 and 57% sensitivity, with 71 and 87% specificity, respectively) and the QuantiFERON Gold assay applied to isolated pleural fluid cells (100% sensitivity and 67% specificity). Conclusion: The ex vivo pleural fluid interferon-γ level is an accurate marker for the diagnosis of pleural TB, and the QuantiFERON TB Gold assay performed with peripheral blood or adapted for pleural fluid cells does not add diagnostic value. Copyright © 2008 S. Karger AG.
dc.description.versionArticle
dc.identifier.citationRespiration
dc.identifier.citation76
dc.identifier.citation2
dc.identifier.issn257931
dc.identifier.other10.1159/000128575
dc.identifier.urihttp://hdl.handle.net/10019.1/10449
dc.subjectgamma interferon
dc.subjectadult
dc.subjectarticle
dc.subjectblood sampling
dc.subjectcell isolation
dc.subjectcytokine release
dc.subjectdiagnostic accuracy
dc.subjectempyema
dc.subjectenzyme assay
dc.subjectevaluation
dc.subjectfemale
dc.subjecthuman
dc.subjectInterferon gamma release assay
dc.subjectlung cancer
dc.subjectmajor clinical study
dc.subjectmale
dc.subjectpleura effusion
dc.subjectpleura fluid
dc.subjectpneumonia
dc.subjectprevalence
dc.subjectpriority journal
dc.subjectsensitivity and specificity
dc.subjectSouth Africa
dc.subjecttuberculous pleurisy
dc.subjectAdult
dc.subjectAged
dc.subjectExtracellular Fluid
dc.subjectFemale
dc.subjectHumans
dc.subjectInterferon-gamma
dc.subjectMale
dc.subjectMiddle Aged
dc.subjectPleural Effusion
dc.subjectT-Lymphocytes
dc.subjectTuberculosis, Pleural
dc.titleEvaluation of adapted whole-blood interferon-γ release assays for the diagnosis of pleural tuberculosis
dc.typeArticle
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