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Memórias do Instituto Oswaldo Cruz
Fundação Oswaldo Cruz, Fiocruz
ISSN: 1678-8060 EISSN: 1678-8060
Vol. 109, No. 7, 2014, pp. 863-870
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Bioline Code: oc14128
Full paper language: English
Document type: Research Article
Document available free of charge
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Memórias do Instituto Oswaldo Cruz, Vol. 109, No. 7, 2014, pp. 863-870
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Serial QuantiFERON-TB Gold In-Tube assay and tuberculin skin test to diagnose latent tuberculosis in household Mexican contacts: conversion and reversion rates and associated factors using conventional and borderline zone definitions
Monárrez-Espino, Joel; Enciso-Moreno, José Antonio; Laflamme, Lucie & Serrano, Carmen J.
Abstract
A cohort of 123 adult contacts was followed for 18-24 months (86 completed the follow-up) to compare conversion and reversion rates based on two serial measures of QuantiFERON (QFT) and tuberculin skin test (TST) (PPD from TUBERSOL, Aventis Pasteur, Canada) for diagnosing latent tuberculosis (TB) in household contacts of TB patients using conventional (C) and borderline zone (BZ) definitions. Questionnaires were used to obtain information regarding TB exposure, TB risk factors and socio-demographic data. QFT (IU/mL) conversion was defined as < 0.35 to ≥ 0.35 (C) or < 0.35 to > 0.70 (BZ) and reversion was defined as ≥ 0.35 to < 0.35 (C) or ≥ 0.35 to < 0.20 (BZ); TST (mm) conversion was defined as < 5 to ≥ 5 (C) or < 5 to > 10 (BZ) and reversion was defined as ≥ 5 to < 5 (C). The QFT conversion and reversion rates were 10.5% and 7% with C and 8.1% and 4.7% with the BZ definitions, respectively. The TST rates were higher compared with QFT, especially with the C definitions (conversion 23.3%, reversion 9.3%). The QFT conversion and reversion rates were higher for TST ≥ 5; for TST, both rates were lower for QFT < 0.35. No risk factors were associated with the probability of converting or reverting. The inconsistency and apparent randomness of serial testing is confusing and adds to the limitations of these tests and definitions to follow-up close TB contacts.
Keywords
close contact; QuantiFERON; latent TB; Mexico; serial testing
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