CD4 response of QuantiFERON-TB Gold Plus for positive consistency of latent tuberculosis infection in patients on dialysis

• Published in: Scientific reports Vol. 10; no. 1; p. 21367
• Main Authors: Wang, Ping-Huai, Lin, Shu-Yung, Lee, Susan Shih-Jung, Lin, Shu-Wen, Lee, Chih-Yuan, Wei, Yu-Feng, Shu, Chin-Chung, Wang, Jann-Yuan, Yu, Chong-Jen
• Format: Journal Article
• Language: English
• Published: London Nature Publishing Group UK 07.12.2020; Nature Publishing Group; Nature Portfolio
• Subjects: 692/308; 692/499; 692/53; 692/700; Adult; Aged; Biomarkers - blood; CD4 antigen; CD8 antigen; CD8-Positive T-Lymphocytes - metabolism; Delivery of Health Care; Dialysis; Discordance; Female; Hemodialysis; Humanities and Social Sciences; Humans; Interferon-gamma Release Tests; Latent Tuberculosis - diagnosis; Latent Tuberculosis - immunology; Latent Tuberculosis - therapy; Male; Middle Aged; multidisciplinary; Renal Dialysis; Risk Factors; Science; Science (multidisciplinary); Tuberculosis; γ-Interferon
• ISSN: 2045-2322; 2045-2322
• DOI: 10.1038/s41598-020-78374-3

A significantly negative reversion in the QuantiFERON-TB Gold In-tube (QFT-GIT) test is reported in patients on dialysis, which makes the results unreliable. The CD4 and CD8 responses of the QFT-Gold plus (QFT-Plus) may have better positive consistency, but this needs to be investigated. We enrolled dialysis patients with baseline positive QFT-GIT 0 results and conducted two rounds of follow-up paired QFT-GIT 1&2 and QFT-Plus 1&2 tests at an interval of 6 months. The positive consistency, concordance, and discordance of the QFT results were analyzed. A total of 236 patients on dialysis were screened, and 73 participants with positive QFT-GIT 0 results were enrolled. The baseline QFT-GIT 0 response was higher in the 1st QFT-Plus 1 (+) group than in the QFT-Plus 1 (−) group, but insignificantly different between the 1st QFT-GIT 1 (+) and QFT-GIT 1 (−) groups. The two assays had good correlation when concurrently tested. Fifty-three subjects completed a second round of the QFT-GIT 2 and QFT-Plus 2 . Persistent positivity was higher with the QFT-Plus 2 (81.8%) than with the QFT-GIT 2 (58.8%, p = 0.040). The QFT-GIT 1 and QFT-Plus 1 CD4 responses were higher in patients with persistent positivity than in those with negative reversion, whereas the difference of the QFT-Plus TB1 and TB2 data, representative of the CD8 response, were similar between positive persistence and negative reversion. In conclusion, the QFT-Plus provides more reliable positive consistency than does the QFT-GIT. The CD4 interferon-γ response might play a role in maintaining positivity of LTBI.