In-hospital blood collection increases the rate of indeterminate results in interferon-gamma release assays

Author:

Osakabe Yuki1,Yamaguchi Fumihiro2ORCID,Suzuki Ayako3,Kitano Haruka1,Hiraiwa Mina1,Shiratori Yo1,Onozaki Shota1,Nakamoto Mari1,Kawamura Saori1,Kosuge Miku1,Atarashi Kenji1,Cho Hidekazu1,Shimizu Shohei1,Fujishima Akira1,Shikama Yusuke1

Affiliation:

1. Department of Respiratory Medicine, Showa University Fujigaoka Hospital, Yokohama, Japan

2. Department of Respiratory Medicine, Showa University Fujigaoka Hospital, 1-30 Fujigaoka, Aoba-ku, Yokohama 227-8501, Japan

3. Department of Pharmacy, Showa University Fujigaoka Hospital, Yokohama, Japan

Abstract

Background: The interferon (IFN)-γ release assay (IGRA) has recently been established as a method to evaluate the infection status of tuberculosis instead of the tuberculin skin test. However, indeterminate results can create challenges to interpretation. The IGRA has been available in Japan since 2005, including the recently launched QuantiFERON-TB Gold Plus (QFT-plus) assay. Objectives: The aim of this study was to investigate the clinical features and predictors of indeterminate results by the QFT-plus test in routine practice. Methods: This was a cross-sectional study of 1258 patients. Multivariate logistic regression models were employed to investigate the clinical factors related to indeterminate results by the QFT-plus. Results: Overall, 91.8% of results were found to be conclusive and 8.2% were indeterminate. The QFT-plus indeterminate results were predominantly due to a low level of IFN-γ production by mitogens. Multivariate analysis indicated that an indeterminate result was significantly associated with age, sex, corticosteroid use, autoimmune disease, and inpatient setting. Conclusion: Certain types of individuals are at higher risk of an indeterminate IGRA result. The QFT-plus test for hospitalized patients should be avoided as much as possible, and it is better to perform the test for those patients in outpatient settings.

Publisher

SAGE Publications

Subject

Pharmacology (medical),Pulmonary and Respiratory Medicine

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