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Serial interferon-gamma release assays after chemoprophylaxis in a tuberculosis outbreak cohort.

机译:在结核病暴发队列进行化学预防后,进行系列干扰素-γ释放试验。

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摘要

Interferon-gamma release assay (IGRA) results have been suggested as a surrogate marker of treatment response in latent tuberculosis infection (LTBI). However, data have not been consistent, and most previous studies focused on participants taking isoniazid prophylaxis. The aim of this study was to elucidate the changes in the IGRA results in patients who underwent chemoprophylaxis with isoniazid and rifampicin daily for 3?months.In a TB outbreak cohort, 26 asymptomatic close contacts with normal chest radiographs and positive QuantiFERON-TB Gold In-Tube assay (QFT-GIT) results were recruited. These patients were treated with isoniazid and rifampicin daily for 3?months. The QFT-GIT was repeated at 3 and 6?months following treatment initiation.Compared with the initial QFT-GIT results (3.59?±?3.39?IU/mL), the interferon-gamma (IFN-γ) levels had decreased significantly at 6?months (0.84?±?1.14?IU/mL; P?=?0.005), but not at 3?months (3.58?±?3.64?IU/mL; P?=?0.98). Reversions occurred in seven (26.9?%) patients at 3?months and in an additional two participants at 6?months; a total of nine participants (34.6?%) had reversions. Recent conversion was associated with reversion of the test results (odds ratio?26.3, 95?% confidence interval?3.04-226.6).Chemoprophylaxis with isoniazid and rifampicin generally decreased IFN-γ levels among tuberculosis contacts. However, only a small portion of participants achieved reversion.
机译:有人建议将干扰素-γ释放试验(IGRA)结果作为潜伏性结核感染(LTBI)治疗反应的替代标志物。然而,数据并不一致,并且大多数先前的研究集中于采取异烟肼预防措施的参与者。这项研究的目的是阐明每天用异烟肼和利福平进行化学预防治疗3个月的患者的IGRA结果的变化。在TB暴发队列中,有26例无症状的近距离接触,胸部X光片正常且QuantiFERON-TB Gold In阳性募集了-Tube检测(QFT-GIT)结果。这些患者每天接受异烟肼和利福平治疗3个月。在开始治疗后的3和6个月重复QFT-GIT。与初始QFT-GIT结果(3.59?±?3.39?IU / mL)相比,干扰素-γ(IFN-γ)水平在治疗前显着下降。 6个月(0.84±1.14IU / mL; P = 0.005),而不是3个月(3.58±3.64IU / mL; P = 0.98)。在3个月时有7例(26.9%)患者发生了逆转,在6个月时又有2例患者出现了逆转。共有9位参与者(34.6%)进行了回复。最近的转换与测试结果的恢复有关(几率之比为26.3,95%置信区间为3.04-226.6)。异烟肼和利福平的化学预防通常会降低结核病接触者的IFN-γ水平。但是,只有一小部分参与者实现了回复。

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