PLoS ONE (Jan 2023)

Reversions of QuantiFERON-TB Gold Plus in tuberculosis contact investigation: A prospective multicentre cohort study

  • Sandra Pérez-Recio,
  • Maria D. Grijota-Camino,
  • Luis Anibarro,
  • Ramón Rabuñal-Rey,
  • Josefina Sabria,
  • Paloma Gijón-Vidaurreta,
  • Virginia Pomar,
  • Mercedes García-Gasalla,
  • Ángel Domínguez-Castellano,
  • Matilde Trigo,
  • María Jesús Santos,
  • Alba Cebollero,
  • Sara Rodríguez,
  • Esther Moga,
  • Anton Penas-Truque,
  • Carmen Martos,
  • M. Jesús Ruiz-Serrano,
  • Erika I. Garcia-de-Cara,
  • Fernando Alcaide,
  • Miguel Santin

Journal volume & issue
Vol. 18, no. 8

Abstract

Read online

Background Interferon-y Release Assays (IGRA) reversions have been reported in different clinical scenarios for the diagnosis of tuberculosis (TB) infection. This study aimed to determine the rate of QuantiFERON-TB Gold Plus (QFT-Plus) reversions during contact investigation as a potential strategy to reduce the number of preventive treatments. Methods Prospective, multicentre cohort study of immunocompetent adult contacts of patients with pulmonary TB tested with QFT-Plus. Contacts with an initial positive QFT-Plus (QFT-i) underwent a second test within 4 weeks (QFT-1), and if negative, underwent a repeat test 4 weeks later (QFT-2). Based on the QFT-2 result, we classified cases as sustained reversion if they remained negative and as temporary reversion if they turned positive. Results We included 415 contacts, of whom 96 (23.1%) had an initial positive test (QFT-i). Following this, 10 had negative QFT-1 results and 4 (4.2%) of these persisted with a negative result in the QFT-2 (sustained reversions). All four sustained reversions occurred in contacts with IFN-γ concentrations between ≥0.35 and ≤0.99 IU•mL-1 in one or both QFT-i tubes. Conclusion In this study, TB contact investigations rarely reveal QFT-Plus reversion. These results do not support retesting cases with an initial positive result to reduce the number of preventive treatments.